Healthcare Provider Details

I. General information

NPI: 1770483315
Provider Name (Legal Business Name): NHI Y PHAM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/07/2026
Last Update Date: 11/07/2026
Certification Date: 11/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

835 SE BISHOP BLVD
PULLMAN WA
99163-5512
US

IV. Provider business mailing address

716 E A ST
MOSCOW ID
83843-3312
US

V. Phone/Fax

Practice location:
  • Phone: 509-336-7380
  • Fax:
Mailing address:
  • Phone: 201-486-4061
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License Number61064
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: