Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 101YM0800X | Mental Health Counselor | ||
N | 225X00000X | Occupational Therapist | 392484 | OR |
Y | 225XM0800X | Mental Health | 392484 | OR |
NPI | 1841592441 |
---|---|
Provider Name | Tracy T Nguyen |
First Address | Portland, OR 97202-3365 |
Second Address | Eugene, OR 97401-8122 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/12/2010 |
Last Update Date | 24/05/2019 |