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General NPI Number Information
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NPI Number | 1356357206
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Entity Type | Individual
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Provider Name | THANH HA PHAM O.D.
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Gender | Female
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Dates
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Enumeration Date | 07/31/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2219 S 37TH ST
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City | TACOMA
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State | WA
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Zip | 98409-7473
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Country | US
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Telephone | 252-671-6012
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Fax |
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Provider Business Mailing Address
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Address Line | 14006 SE 90TH ST
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City | NEWCASTLE
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State | WA
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Zip | 98059-3484
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Country | US
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Telephone | 206-818-9320
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Fax | 253-671-6013
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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 | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 3531
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License Number State | WA
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