Individual
DR. KEVIN GIA-MINH PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
12000 SE 82ND AVE STE 2193, HAPPY VALLEY, OR 97086-7746
(503) 654-6217
(503) 654-9335
Mailing address
11084 SE 64TH AVE, PORTLAND, OR 97222-2319
(503) 890-7209
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
4708
OR
152W00000X
Optometrist
60964432
WA
Other
Enumeration date
10/24/2019
Last updated
09/12/2023
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