Individual
PHUONG T PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
8122 SE TIBBETTS ST, PORTLAND, OR 97206-1768
(503) 255-1111
Mailing address
5108 SW SCHOLLS FERRY RD APT D101, PORTLAND, OR 97225-1672
(571) 405-9079
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RPH-0018092
OR
Other
Enumeration date
10/28/2020
Last updated
10/28/2020
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