Healthcare Provider Details

I. General information

NPI: 1124397625
Provider Name (Legal Business Name): MINH PHAM PHARM D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/29/2011
Last Update Date: 06/02/2026
Certification Date: 06/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11325 SE MILL PLAIN BLVD STE F
VANCOUVER WA
98684-5099
US

IV. Provider business mailing address

11325 SE MILL PLAIN BLVD STE F
VANCOUVER WA
98684-5099
US

V. Phone/Fax

Practice location:
  • Phone: 360-253-7086
  • Fax: 360-253-7083
Mailing address:
  • Phone: 360-253-7086
  • Fax: 360-253-7083

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0012964
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60729256
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: