Vayakone Philavanh, LDO

Primary specialty

OpticianTaxonomy code 156FX1800X

License

DO00002172 Issued in WA

Practice address

19500 SE Stark St
Portland, OR 97233-5757

Phone

(503) 669-3995

Fax

(503) 669-3956

NPI assigned

Aug 25, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1156464000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1710094560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22298 NE FAILING ST",
            "city": "FAIRVIEW",
            "state": "OR",
            "postal_code": "970248758",
            "telephone_number": "503-669-3995",
            "fax_number": "503-669-3656"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19500 SE STARK ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972335757",
            "telephone_number": "503-669-3995",
            "fax_number": "503-669-3956"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILAVANH",
        "first_name": "VAYAKONE",
        "name_prefix": "Mrs.",
        "credential": "LDO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-25",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1800X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Optician",
            "state": "WA",
            "license": "DO00002172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mackenzie Phelps
• Michael Phelps
• Michael Sean Phelps, CPHT
• Randi Ann Phelps, PHD
• Kerry E M Phifer, PMHNP
• Vieng Tran Philavanh
• Kingsavanh Paul Philavong, PHARMD
• Michelle Philbrick
• Philip J. Gross D.D.S., P.C.
• Travis Campbell Philipp, MD

• Optician in Portland, OR
• Providers in Portland, OR by specialty
• Optician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.