Healthcare Provider Details

I. General information

NPI: 1285727545
Provider Name (Legal Business Name): HUONG T PHAM MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2006
Last Update Date: 09/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 9TH AVE
SEATTLE WA
98101-2756
US

IV. Provider business mailing address

1100 OLIVE WAY # MS /M4-PA
SEATTLE WA
98101-1873
US

V. Phone/Fax

Practice location:
  • Phone: 206-223-6600
  • Fax:
Mailing address:
  • Phone: 206-515-5811
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License NumberMD00039319
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: