Individual
KEVIN PHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4444 LACEY BLVD SE STE E, LACEY, WA 98503-5730
(360) 999-9848
Mailing address
1413 32ND PL NE, AUBURN, WA 98002-2359
(425) 919-4333
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
07/05/2025
Last updated
07/05/2025
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