Individual
DR. HIEU PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
12596 SE STARK ST, BLDG N, PORTLAND, OR 97233-1056
(503) 528-4758
Mailing address
4305 NE GLISAN ST, PORTLAND, OR 97213-1641
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D10274
OR
Other
Enumeration date
07/14/2015
Last updated
07/14/2015
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