Healthcare Provider Details

I. General information

NPI: 1528922788
Provider Name (Legal Business Name): NINMI PHAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/12/2025
Last Update Date: 12/12/2025
Certification Date: 12/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

101 W 8TH AVE
SPOKANE WA
99204-2307
US

IV. Provider business mailing address

8808 N INDIAN TRAIL RD APT 4108
SPOKANE WA
99208-9187
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-3131
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRM.PH.61687283
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: