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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MIN-U TAN

Active

122400000X · BEAVERTON, OR

Registration Details

NPI Number
1629777552
Provider Type
Individual
Gender
Male
NPI Issued
Feb 28, 2023 (3.1637469283879 yrs)
Last Updated
Feb 28, 2023
Licenses
DN61216096 (WA)
DT-DO-10222225 (OR)

Practice Information

Address
4855 SW WESTERN AVE
BEAVERTON, OR, 970053499
Browse OR providers · Browse ZIP 97005
Phone
5038132000
Primary Specialty
122400000X
122400000X
Additional Specialty
Dental Laboratory Technician
Additional Specialty
122400000X

Other 122400000X Providers in BEAVERTON, OR

Name Credential NPI
MICHAEL MOGA LD 1730226333
MRS. ESTHER C OH 1730391087
KRISTINE S. BAHNG LD 1992918361
JEFFREY JACKY DENTURIST LD 1356791677
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.