Individual
THAO PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
15147 NE KLICKITAT ST, PORTLAND, OR 97230-4528
(503) 820-9317
Mailing address
15147 NE KLICKITAT ST, PORTLAND, OR 97230-4528
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
06/21/2023
Last updated
06/21/2023
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