Individual
THANH V PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
30809 1ST AVE S, FEDERAL WAY, WA 98003-4074
(253) 839-2030
Mailing address
30809 1ST AVE S, FEDERAL WAY, WA 98003-4074
(253) 839-2030
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00038413
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1044623
—
WA
01
—
138971
STATE L&I
WA
01
—
156570
STATE L&I
WA
Enumeration date
07/03/2006
Last updated
12/08/2020
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