Provider Demographics
NPI:1972545101
Name:LAM, POLLYANNA (DO)
Entity Type:Individual
Prefix:MS
First Name:POLLYANNA
Middle Name:
Last Name:LAM
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:605 E HOLLAND AVE STE 101
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1246
Mailing Address - Country:US
Mailing Address - Phone:509-342-3010
Mailing Address - Fax:
Practice Address - Street 1:605 E HOLLAND AVE STE 101
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1246
Practice Address - Country:US
Practice Address - Phone:509-341-3010
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2022-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60976676208000000X
SCDO83004208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics