Individual
MR. LAN N PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1615 DELAWARE ST, LONGVIEW, WA 98632-2367
(360) 501-3601
(360) 501-3648
Mailing address
1115 SE 164TH AVE, DEPT. 358, VANCOUVER, WA 98683-9324
(360) 729-1462
(360) 729-3104
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00037318
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0256048
WASHINGTON DOL
WA
05
—
8248452
—
WA
Enumeration date
06/09/2005
Last updated
03/06/2017
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