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General NPI Number Information
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NPI Number | 1801790704
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Entity Type | Individual
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Provider Name | ALEXIA PHAM
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Gender |
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Dates
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Enumeration Date | 10/05/2026
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Last Update Date | 10/05/2026
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Provider Practice Location Address
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Address Line | 5025 SE 28TH AVE
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City | PORTLAND
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State | OR
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Zip | 97202-4445
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Country | US
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Telephone | 800-813-2000
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Fax |
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Provider Business Mailing Address
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Address Line | 21290 PATRICIA LN
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City | FAIRVIEW
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State | OR
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Zip | 97024-6770
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Country | US
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Telephone |
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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 | 124Q00000X
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Taxonomy Name | Dental Hygienist
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License Number | H9376
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License Number State | OR
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