ETHAN TAN PHAN PHARMD
NPI 1629805833
Pharmacist in Nampa, ID

Active since September 19, 2024
9850 W ST LUKES DR, NAMPA, ID 83687(208) 381-6161 Get Directions Write a Review

NPPES record last updated: September 19, 2024. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Ethan Tan Phan Pharmd NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ETHAN TAN PHAN PHARMD (NPI 1629805833) is an individual pharmacist in Nampa, Idaho, licensed in Idaho (3061173) and active in the NPI registry since September 2024.

NPPES Registry Identity

NPI1629805833
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameETHAN TAN PHANCredential: PHARMD
Location Address9850 W ST LUKES DRNampa, ID 83687-7912
Mailing Address9850 W St Lukes DrNampa, ID 83687-7912 · (208) 381-6161
Sole ProprietorNo
Enumeration DateSeptember 19, 2024
NPPES CertifiedSeptember 19, 2024
NPI 1629805833 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in ID · 3061173
Definition

An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care.

9850 W ST LUKES DR, Nampa, ID 83687

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Psychiatry)
9850 W ST LUKES DR
NAMPA, ID 83687
Social Worker (Clinical)
9850 W ST LUKES DR
NAMPA, ID 83687
Nurse Practitioner
9850 W ST LUKES DR
NAMPA, ID 83687
Pharmacist
9850 W ST LUKES DR
NAMPA, ID 83687
Pharmacist (Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist)
9850 W ST LUKES DR
NAMPA, ID 83687
Family Medicine
9850 W ST LUKES DR
NAMPA, ID 83687
Family Medicine
9850 W ST LUKES DR
NAMPA, ID 83687
Orthopaedic Surgery
9850 W ST LUKES DR
NAMPA, ID 83687

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ethan Phan's NPI number?

The NPI number for Ethan Phan is 1629805833. It was assigned to this individual provider in the NPPES registry on September 19, 2024.

Where is Ethan Phan located?

Ethan Phan practices at 9850 W St Lukes Dr, Nampa, ID 83687. The listed phone number is (208) 381-6161.

What is Ethan Phan's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Ethan Phan was last updated on September 19, 2024. NPI Profile syncs with the weekly NPPES data releases published by CMS.