Thien-Huong Theresa Van, PA
Physician Assistant in Portland, OR. Individual provider (NPI-1).
NPI number1164072286
StatusActive
Last updated in NPPESOct 1, 2024
Details
- NPI
- 1164072286
- Entity type
- Individual (NPI-1)
- Name
- Thien-Huong Theresa Van
- Credential
- PA
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Sep 19, 2019
- Certification date
- Oct 1, 2024
- Last updated
- Oct 1, 2024
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | – | – | Yes |
| 363AM0700X | Physician Assistant, Medical | PA202904 | OR |
Other names
- Theresa Van (Professional Name)
Practice location
4816 Nw Bethany BlvdPortland, OR 97229-9254
Phone 888-227-3312 · Fax 971-282-0100
Mailing address
4816 Nw Bethany BlvdPortland, OR 97229-9254
Phone 888-227-3312 · Fax 971-282-0100
Other practice locations
3031 Ne Stephens St
Roseburg, OR 97470-6237
Roseburg, OR 97470-6237
Phone 541-229-7038 · Fax 541-464-4474
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