Healthcare Provider Details

I. General information

NPI: 1437585767
Provider Name (Legal Business Name): RONNA KAY BOND RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2013
Last Update Date: 09/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2330 NEZ PERCE DR
LEWISTON ID
83501-4107
US

IV. Provider business mailing address

2153 QUAILWOOD DR
CLARKSTON WA
99403-1743
US

V. Phone/Fax

Practice location:
  • Phone: 208-798-0481
  • Fax: 208-798-0715
Mailing address:
  • Phone: 509-758-8855
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberP4717
License Number StateID

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: