Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1629805833 Individual Practitioner Male Practitioner

Dr. Ethan Tan Phan , PharmD

Pharmacist • Nampa, ID

Professional Overview & Biography Verified Profile Summary

Dr. Ethan Phan, PharmD is a registered healthcare professional specializing in Pharmacist in Nampa, ID. Practice services are available at 9850 W ST LUKES DR under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9850 W St Lukes Dr

Nampa, ID 836877912

Telephone 2083816161
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pharmacist in Nampa, ID

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 10.2 Yrs
Regional Practice Density
111 Specialists

Practicing in Nampa, ID (1793 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2024-09-19
Pharmacist Primary Specialty

NUCC Taxonomy Code: 183500000X

State License ID 3061173

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. John-Minh Nguyen , DO

Psychiatry & Neurology - Psychiatry

NPI 1013322783

Doctor of Osteopathic Medicine (D.O.)

Lindsay Nelson , LMSW

Social Worker - Clinical

NPI 1043808363

Licensed Master Social Worker

Bonnie Hoewing , NP

Nurse Practitioner

NPI 1063879633

Nurse Practitioner

NPI 1073380382

Doctor of Pharmacy (Pharm.D.)

Dr. Patricia Aggers , PharmD

Pharmacist - Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI 1093973455

Doctor of Pharmacy (Pharm.D.)

NPI 1104481555

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active September 19, 2024

NPI status registered as active in NPPES database

📍
Updated Practice Location September 19, 2024

Registered at 9850 W ST LUKES DR, NAMPA, ID 836877912 (Tel: 2083816161)

📍
Updated Business Mailing Address September 19, 2024

Registered at 9850 W ST LUKES DR, NAMPA, ID 836877912 (Tel: 2083816161)

👤
Provider Name / Credentials Updated September 19, 2024

Recorded as ETHAN PHAN, PHARMD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) September 19, 2024

Pharmacist (License #3061173 in ID)

🟢
Initial NPI Registration & Enumeration September 19, 2024

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Ethan Phan. Be the first to share your experience!

Sign in to leave a review for Dr. Ethan Phan

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1629805833
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: September 19, 2024
Last Update: September 19, 2024
Sole Proprietor: No

Mailing Address

9850 W St Lukes Dr

Nampa, ID 836877912

Phone: 2083816161

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.