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Individual

DR. PATRICK T PHAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2902 112TH AVE SE, BELLEVUE, WA 98004-7528
(206) 725-4322
Mailing address
PO BOX 649, FORT DEFIANCE, AZ 86504-0649
(928) 729-8000

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00026346
WA
208D00000X
General Practice Physician
MD00026346
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1029150
WA
Enumeration date
01/25/2008
Last updated
10/07/2014
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