Van, Thao
Van, Thao is an individual health care provider with primary practice located at 12345 Sw Horizon Blvd Ste 57 , Beaverton OR 97007-9475. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as her primary health care specialty. Van, Thao can be contacted via phone (503) 216-8820.Contact Information
Primary practice address
12345 Sw Horizon Blvd Ste 57
Beaverton OR 97007-9475
Phone: (503) 216-8820
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA60719666 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA169942 | Oregon |
Profile Details
| NPI number | 1467851600 |
|---|---|
| LBN Legal business name | Van, Thao |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 13th, 2014 |
| Last updated | Oct 13th, 2021 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1467851600 | NPPES |
| Oregon | MEDICAID | 500677387 |
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