Active NPI
Vivian Nguyen
- Occupational Therapist
- Gresham, OR
National Provider Identifier
1790419562
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 468092
- Practice address
- 24800 SE Stark St
Gresham, OR 97030-3378 - Phone
- (503) 442-9792
- NPI assigned
- Jul 15, 2022
- Last updated
- Sep 6, 2022
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 468092 | OR | Primary |
Addresses
Primary practice location
24800 SE Stark St
Gresham, OR 97030-3378
Mailing address
16676 SE Fox Glen CT
Happy Valley, OR 97015-8728
Phone (503) 442-9792
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 468092 | OR | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1657843200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1662422400000",
"number": "1790419562",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "16676 SE FOX GLEN CT",
"city": "HAPPY VALLEY",
"state": "OR",
"postal_code": "970158728",
"telephone_number": "503-442-9792"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24800 SE STARK ST",
"city": "GRESHAM",
"state": "OR",
"postal_code": "970303378",
"telephone_number": "503-442-9792"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NGUYEN",
"first_name": "VIVIAN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2022-07-15",
"last_updated": "2022-09-06",
"certification_date": "2022-08-13",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "OR",
"license": "468092",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gresham, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.