Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | MD00045085 | WA |
N | 208600000X | Surgeon | MD00045085 | WA |
Y | 2086S0102X | Surgical Critical Care | MD00045085 | WA |
NPI | 1326153040 |
---|---|
Provider Name | Tam N Pham |
First Address | Seattle, WA 98145-5095 |
Second Address | Seattle, WA 98104-2420 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/02/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0231832 | L&I (01) | WA |
1326153040 | (05) | WA |