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General NPI Number Information
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NPI Number | 1417576968
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Entity Type | Individual
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Provider Name | TAN TRAN PHARMD
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Gender | Male
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Dates
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Enumeration Date | 04/15/2020
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Last Update Date | 03/03/2025
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Provider Practice Location Address
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Address Line | 1350 N 1ST ST
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City | HERMISTON
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State | OR
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Zip | 97838-1102
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Country | US
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Telephone | 541-567-4854
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 190
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City | TOPPENISH
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State | WA
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Zip | 98948-0190
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Country | US
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Telephone | 509-865-2395
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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 | PH61068367
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | RPH-0017832
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License Number State | OR
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