DR. KEVIN GIA-MINH PHAN (NPI# 1164065959) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1164065959 |
| Entity Type | Individual |
| Full Name | DR. KEVIN GIA-MINH PHAN |
| Credential | OD |
| Practice Address |
Walla Walla Vamc Bldg 86 Walla Walla WA 99362 |
| Mailing Address |
11084 Se 64th Ave Portland OR 97222-2319 |
| Practice Telephone | 5095255200 |
| Mailing Telephone | 5038907209 |
| Enumeration Date | 2019-10-24 |
| Last Update Date | 2019-10-24 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 152W00000X | Optometrist | 60964432 | WA | Eye and Vision Services Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629586706 | Kevin Phan | Student in an Organized Health Care Education/Training Program | 9800 Vesper Ave Unit 142, Panorama City, CA 91402-1093 | 2018-01-11 |
| 1174907273 | Kevin Phan | Optometrist | 165 East 87th St 1rw, New York, CA 10128 | 2015-07-17 |
| 1013335785 | Kevin Phan | Student in an Organized Health Care Education/Training Program | 504 N Forbes Ave, Montebello, CA 90640-3732 | 2014-03-31 |
| 1922238385 | Kevin Vu Phan | Dentist | 5530 W Grand Pkwy S, Suite 100, Richmond, TX 77406-5802 | 2009-07-20 |
| 1912079906 | Kevin Huy Phan | Chiropractor | 1820 Professional Dr Ste 2, Sacramento, CA 95825-2120 | 2006-11-14 |
| 1649807876 | Kevin Phan | Student in an Organized Health Care Education/Training Program | 276 International Cir, San Jose, CA 95119-1130 | 2020-03-26 |
| 1083247225 | Kevin Phan | Behavior Technician | 6516 Broadway St, Suite 112, Pearland, TX 77581-7880 | 2020-02-17 |
| 1932740610 | Kevin Phan | Student in an Organized Health Care Education/Training Program | 12440 Firestone Blvd Ste 3020, Norwalk, CA 90650-9328 | 2019-10-03 |
| 1225532005 | Kevin Taiduc Phan | Behavior Technician | 1485 Saratoga Ave Ste 200, San Jose, CA 95129-4965 | 2018-03-19 |
| 1033539150 | Kevin Ht Phan | Orthopaedic Surgery | 1111 Leffingwell Ave Ne, Grand Rapids, MI 49525-6406 | 2014-04-17 |
| Street Address |
WALLA WALLA VAMC BLDG 86 |
| City | WALLA WALLA |
| State | WA |
| Zip Code | 99362 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659836401 | Arlene Lavonne Whitney | Social Worker | 1361 Dalles Military Road, Walla Walla, WA 99362 | 2019-02-06 |
| 1053880674 | Julie Ann Cooke | Speech-Language Pathologist | Providence St. Mary Medical Center, 401 W. Poplar St., Walla Walla, WA 99362 | 2018-11-14 |
| 1558887133 | Chantey Walker | Massage Therapist | 1840 Pleasant St, Walla Walla, WA 99362 | 2017-08-16 |
| 1447798723 | Carrie S Diede | Speech-Language Pathologist | 410 West Poplar Street, Rehabilitation Services, Walla Walla, WA 99362 | 2017-02-07 |
| 1235584103 | Anchor Point Counseling Pllc | Clinic/Center | 2330 Eastgate St. Ste. 140, Walla Walla, WA 99362 | 2016-04-28 |
| 1548627011 | Washington State Walla Walla Veterans Home | Skilled Nursing Facility | 92 Wainwright Drive, Walla Walla, WA 99362 | 2016-01-28 |
| 1073926200 | Sherry Goff | Registered Nurse | 11120 W Rose St, Family Medical Center, Walla Walla, WA 99362 | 2014-06-05 |
| 1538597935 | Michael Wade Gillespie | Orthopaedic Surgery | 101 Brookside Drive, Walla Walla, WA 99362 | 2013-10-22 |
| 1023357985 | Sandra Kay Bushnell | Speech-Language Pathologist | 1105 Isaacs Ave, Walla Walla, WA 99362 | 2013-02-12 |
| 1518210319 | Evelyn Martindale | Nurse Practitioner | 401 W. Poplar Street, Walla Walla, WA 99362 | 2012-10-18 |
| Find all providers in zip 99362 | ||||
| Taxonomy Code | 152W00000X |
| Grouping | Eye and Vision Services Providers |
| Classification | Optometrist |
| Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye. An optometrist has completed pre-professional undergraduate education in a college or university and four years of professional education at a college of optometry, leading to the doctor of optometry (O.D.) degree. Some optometrists complete an optional residency in a specific area of practice. Optometrists are eye health care professionals state-licensed to diagnose and treat diseases and disorders of the eye and visual system. |
| Notes: Source: American Optometric Association (AOA), approved by the AOA’s Board of Trustees, June 21, 2005. [7/1/2006: definition modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598301616 | Judy Quach | Optometrist | 2316 Eastgate St Ste 170, Walla Walla, WA 99362-1576 | 2019-11-24 |
| 1528612140 | Trinity Vision Center LLC | Optometrist | 2200 Melrose St Ste 7a, Walla Walla, WA 99362-1579 | 2019-07-31 |
| 1851537021 | Vision Source Walla Walla | Optometrist | 614 East Alder St, Walla Walla, WA 99362-2073 | 2008-12-18 |
| 1578642500 | Rosanne F Schneller | Optometrist | 614 E Alder St Ste 1, Walla Walla, WA 99362-2073 | 2006-11-02 |
| 1891708616 | Bradley Kyle Nielson | Optometrist | 208 N 2nd Ave, Walla Walla, WA 99362-1806 | 2006-08-14 |
| 1710971528 | Barbara June Hetrick | Optometrist | 77 Wainwright Dr, Vamc Eye Clinic, 123, Walla Walla, WA 99362-3975 | 2005-09-07 |
| 1528671351 | Michelle Marie Hammond | Optometrist | 77 Wainwright Dr, Walla Walla, WA 99362-3975 | 2020-08-31 |
| 1053953596 | Eugene Wyn Cheung | Optometrist | 77 Wainwright Dr Bldg 140, Walla Walla, WA 99362-3975 | 2019-10-16 |
| 1144711086 | Emily Rose Freeman | Optometrist | 77 Wainwright Dr, Walla Walla, WA 99362 | 2018-05-26 |
| 1194245043 | Eric John Wiessner | Optometrist | 614 E Alder St Ste 1, Walla Walla, WA 99362-2073 | 2017-06-21 |
| Find all providers in WALLA WALLA | ||||
| City | WALLA WALLA |
| Zip Code | 99362 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.