Organization
POWERED BY SELF LOVE OREGON LLC
Active
Other names
Powered By Self Love Oregon LLC
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LOAN PHAM DOCTOR OF NURSE PRAC (FOUNDER, CEO)
(714) 880-5065
Entity
Organization
Contact information
Practice address
5305 RIVER RD N STE B1, KEIZER, OR 97303-5324
(657) 321-9765
(229) 218-2667
Mailing address
16027 BROOKHURST ST STE I-732, FOUNTAIN VALLEY, CA 92708-1551
(657) 321-9765
(229) 218-2667
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
—
—
Other
Enumeration date
04/13/2022
Last updated
11/07/2022
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