Individual
SHAWN LOU PHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
14212 AMBAUM BLVD SW STE 1, BURIEN, WA 98166-1437
(206) 343-0000
Mailing address
650 DUVALL AVE NE APT R1323, RENTON, WA 98059-4775
(253) 222-9269
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DENT.DE.61184555
WA
Other
Enumeration date
06/16/2021
Last updated
06/16/2021
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