Healthcare Provider Details

I. General information

NPI: 1316723133
Provider Name (Legal Business Name): VIVIAN NGOC PHAM RPH, PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/06/2023
Last Update Date: 11/21/2025
Certification Date: 11/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

737 FAWCETT AVE STE 334
TACOMA WA
98402-5503
US

IV. Provider business mailing address

10015 DIBBLE AVE NW
SEATTLE WA
98177-5145
US

V. Phone/Fax

Practice location:
  • Phone: 253-777-4806
  • Fax:
Mailing address:
  • Phone: 714-587-7967
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61448697
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: