Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | MD60644411 | WA |
NPI | 1124461694 |
---|---|
Provider Name | Do-Quyen Pham |
First Address | Seattle, WA 98105-3941 |
Second Address | Seattle, WA 98105-3941 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/04/2013 |
Last Update Date | 01/08/2019 |