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General NPI Number Information
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NPI Number | 1215741251
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Entity Type | Individual
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Provider Name | ANALEE AINHUTRAN PHAM PHARMD
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Gender | Female
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Dates
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Enumeration Date | 02/01/2025
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Last Update Date | 02/01/2025
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Provider Practice Location Address
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Address Line | 301 E WALLACE KNEELAND BLVD
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City | SHELTON
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State | WA
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Zip | 98584-2985
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Country | US
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Telephone | 360-432-5373
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 FONES RD SE APT 2-101
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City | OLYMPIA
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State | WA
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Zip | 98501-7415
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Country | US
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Telephone | 971-267-7058
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH61571227
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License Number State | WA
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