Individual
MRS. KRISTINE H PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
1300 NE 134TH STREET, VANCOUVER, WA 98685-2747
(360) 546-5208
(360) 574-2878
Mailing address
7012 NE 40TH STREET, VANCOUVER, WA 98661-3052
(360) 254-5254
(360) 944-3835
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE00009152
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0158866
LABOR & INDUSTRIES
WA
05
—
5038997
—
WA
01
—
8932838
CRIME VICTIMS
WA
Enumeration date
11/28/2006
Last updated
07/08/2007
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