Individual
DR. IAN PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
18791 SW BOONES FERRY RD, SUITE 3, TUALATIN, OR 97062-8412
(503) 692-6552
(503) 692-1452
Mailing address
18791 SW BOONES FERRY RD, SUITE 3, TUALATIN, OR 97062-8412
(503) 692-6552
(503) 692-1452
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D7808
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
D7808
STATE LICENSE
OR
Enumeration date
03/25/2006
Last updated
03/07/2023
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