Individual
JACQUELINE O PHAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8155 SW HALL BLVD, BEAVERTON, OR 97008-6416
(503) 643-3443
(503) 643-4309
Mailing address
8155 SW HALL BLVD, BEAVERTON, OR 97008-6416
(503) 643-3443
(503) 643-4309
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
10766
OR
Other
Enumeration date
06/12/2012
Last updated
06/12/2012
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