Provider Demographics
NPI:1487196887
Name:LAM, THANH D (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:THANH
Middle Name:D
Last Name:LAM
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13208 SE NORMANDY DR
Mailing Address - Street 2:
Mailing Address - City:CLACKAMAS
Mailing Address - State:OR
Mailing Address - Zip Code:97015-6487
Mailing Address - Country:US
Mailing Address - Phone:503-442-5864
Mailing Address - Fax:
Practice Address - Street 1:13208 SE NORMANDY DR
Practice Address - Street 2:
Practice Address - City:CLACKAMAS
Practice Address - State:OR
Practice Address - Zip Code:97015-6487
Practice Address - Country:US
Practice Address - Phone:503-442-5864
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-16
Last Update Date:2016-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR0010633183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist