Individual
THERESE THUYTIEN PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2500 MAIN AVE N, TILLAMOOK, OR 97141-7784
(503) 815-1433
(503) 815-1427
Mailing address
2500 MAIN AVE N, TILLAMOOK, OR 97141-7784
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH60875220
WA
183500000X
Pharmacist
RPH-0016992
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0016992
OR
Other
Enumeration date
11/04/2018
Last updated
07/16/2020
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