Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DE00009828 | WA |
N | 1223G0001X | General Practice | D7547 | OR |
N | 213EG0000X | General Practice | D7547 | OR |
NPI | 1639281983 |
---|---|
Provider Name | Dr. Peter Vu |
First Address | Portland, OR 97213 |
Second Address | Vancouver, WA 98682-5001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/08/2006 |
Last Update Date | 21/10/2020 |