Individual
QUOC T PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4800 COLLEGE ST SE, LACEY, WA 98503-4389
(360) 486-2900
(360) 486-2901
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60469189
WA
Other
Enumeration date
04/11/2007
Last updated
05/01/2024
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