MEDICARE: VIRGINIA PHAM RN, EAMP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	171100000X	Acupuncturist	TP60198313	WA

General Provider Information

NPI Number	:	1083917157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	VIRGINIA PHAM RN, EAMP

Provider Business Mailing Address
First Line	:	3303 S LLOYD LN
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99223-7056
Country	:	US
Telephone Number	:	509-294-4907
Fax Number	:

Provider Business Practice Location Address
First Line	:	2204 E 29TH AVE STE 208
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99203-3961
Country	:	US
Telephone Number	:	509-294-4907
Fax Number	:	509-534-2075

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/13/2010
Last Update Date	:	11/26/2024

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