Active NPI
Eddie Trong Nguyen, PHARMD
- Pharmacist
- Portland, OR
National Provider Identifier
1619653698
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P10760
- Practice address
- 3710 SW US Veterans Hospital Road
Portland, OR 97239 - Phone
- (503) 721-1481
- NPI assigned
- Jun 26, 2023
- Last updated
- Sep 24, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P10760 | ID | Primary |
Addresses
Primary practice location
3710 SW US Veterans Hospital Road
Portland, OR 97239
Mailing address
3939 S Bond Ave. Apt. 303
Portland, OR 97239
Phone (310) 406-6761
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P10760 | ID | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1687737600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1695513600000",
"number": "1619653698",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3939 S BOND AVE. APT. 303",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "310-406-6761"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3710 SW US VETERANS HOSPITAL ROAD",
"city": "PORTLAND",
"state": "OR",
"postal_code": "97239",
"telephone_number": "503-721-1481"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "EDDIE",
"middle_name": "TRONG",
"name_prefix": "Mr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-06-26",
"last_updated": "2023-09-24",
"certification_date": "2023-09-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "ID",
"license": "P10760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Portland, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 24, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.