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NPI Code Detail

MEDICARE: KHIEM PHAM

MEDICARE: KHIEM PHAM
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistPH60735921WA

General Provider Information

NPI Number : 1851810295
Entity Type Code : Individual
Provider Name (Legal Business Name) : KHIEM PHAM
Provider Business Mailing Address
First Line : 5200 238TH LN SE
Second Line :
City : ISSAQUAH
State : WA
Zip : 98029-7670
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 500 S PIONEER WAY
Second Line :
City : MOSES LAKE
State : WA
Zip : 98837-1812
Country : US
Telephone Number : 509-765-1219
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/18/2017
Last Update Date : 09/18/2017

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Directions to “ KHIEM PHAM ” Practice Location

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