Individual
MI PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5824 SE 134TH PL, PORTLAND, OR 97236-2987
(503) 810-4681
Mailing address
5824 SE 134TH PL, PORTLAND, OR 97236-2987
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH.61035541
WA
Other
Enumeration date
07/26/2020
Last updated
07/27/2020
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