Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2081P2900X | Pain Medicine | 34009539 | OH |
NPI | 1306047345 |
---|---|
Provider Name | Kenneth X Nguyen |
First Address | Portland, OR 97208-3158 |
Second Address | Portland, OR 97213-2990 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/05/2007 |
Last Update Date | 15/02/2021 |