Provider Demographics
NPI:1962011676
Name:NGUYEN, TRAM ANH (AUD)
Entity type:Individual
Prefix:
First Name:TRAM ANH
Middle Name:
Last Name:NGUYEN
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9280 SE SUNNYBROOK BLVD
Mailing Address - Street 2:STE 300
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-9353
Mailing Address - Country:US
Mailing Address - Phone:503-233-5548
Mailing Address - Fax:503-230-1009
Practice Address - Street 1:3099 RIVER RD S
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-9754
Practice Address - Country:US
Practice Address - Phone:971-209-4551
Practice Address - Fax:503-485-2168
Is Sole Proprietor?:No
Enumeration Date:2020-07-28
Last Update Date:2022-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR30977231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist