MEDICARE: KAILEY M PHILLIPS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	60789839	WA

General Provider Information

NPI Number	:	1033753694
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KAILEY M PHILLIPS PHARMD

Provider Business Mailing Address
First Line	:	24499 E PINNACLE CT UNIT A
Second Line	:
City	:	LIBERTY LAKE
State	:	WA
Zip	:	99019-4506
Country	:	US
Telephone Number	:	509-842-4161
Fax Number	:

Provider Business Practice Location Address
First Line	:	1802 N MONROE ST
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99205-4528
Country	:	US
Telephone Number	:	509-343-6252
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/06/2019
Last Update Date	:	11/06/2019

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Directions to “ KAILEY M PHILLIPS PHARMD” Practice Location

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