Individual
MIA LAM TRAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5721 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7557
Mailing address
5721 NE 138TH AVE, PORTLAND, OR 97230-3409
(503) 261-7557
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0014963
OR
Other
Enumeration date
10/28/2016
Last updated
10/28/2016
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