Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 156FX1800X | Optician |
NPI | 1194090811 |
---|---|
Provider Name | Mr. Huy D. Vu |
First Address | Tigard, OR 97223-4335 |
Second Address | Tigard, OR 97223-4335 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/03/2012 |
Last Update Date | 13/03/2012 |