Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Ethan Tan Phan, PHARMD

Individual provider Pharmacist · NPI 1629805833

Ethan Tan Phan, PHARMD is a Pharmacist in Nampa, Idaho. Licensed in Idaho. Registered with an NPI since 2024.

Licensed in
ID
In the registry since
2024
What do these letters mean?
PHARMD — Doctor of Pharmacy
The professional degree required to practise as a pharmacist in the United States.

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Practice location Address checks out

9850 W St Lukes Dr
Nampa, ID 83687-7912
Phone: (208) 381-6161
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence 3061173 (ID)

Record details

NPI number1629805833
Entity typeIndividual (Type 1)
GenderMale
Credentials PHARMD
Sole proprietorNo
NPI enumeratedSeptember 19, 2024
Last updated in NPPESSeptember 19, 2024
Certification dateSeptember 19, 2024
Mailing address9850 W St Lukes Dr, Nampa, ID 83687-7912

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