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:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467851600 NPPES
Oregon MEDICAID 500677387

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