Provider Demographics
NPI:1528671591
Name:DINH, THO THIEN AI DUC (RPH)
Entity type:Individual
Prefix:
First Name:THO
Middle Name:THIEN AI DUC
Last Name:DINH
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16610 NW AVONDALE DR
Mailing Address - Street 2:
Mailing Address - City:BEAVERTON
Mailing Address - State:OR
Mailing Address - Zip Code:97006-7753
Mailing Address - Country:US
Mailing Address - Phone:713-425-9261
Mailing Address - Fax:
Practice Address - Street 1:3328 NE 3RD AVE
Practice Address - Street 2:
Practice Address - City:CAMAS
Practice Address - State:WA
Practice Address - Zip Code:98607-2436
Practice Address - Country:US
Practice Address - Phone:360-835-3303
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-28
Last Update Date:2020-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0017803183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX65657OtherTEXAS PHARMACIST LICENSE NUMBER