Provider Demographics
NPI:1285873349
Name:LAM-QUAN, TINA TRANG (FNP)
Entity type:Individual
Prefix:MS
First Name:TINA
Middle Name:TRANG
Last Name:LAM-QUAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:150 NE HAWTHORNE AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-4690
Mailing Address - Country:US
Mailing Address - Phone:458-256-9594
Mailing Address - Fax:530-316-5921
Practice Address - Street 1:150 NE HAWTHORNE AVE STE 104
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-4690
Practice Address - Country:US
Practice Address - Phone:458-256-9594
Practice Address - Fax:530-316-5921
Is Sole Proprietor?:No
Enumeration Date:2009-02-12
Last Update Date:2022-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR201802339NP-PP363LF0000X
CA18483363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily