Healthcare Provider Details

I. General information

NPI: 1912237256
Provider Name (Legal Business Name): BETTY J WHITE RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/09/2010
Last Update Date: 01/09/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2702 N ARGONNE RD
MILLWOOD WA
99212-2305
US

IV. Provider business mailing address

7712 E GARNET LN
SPOKANE WA
99212-3527
US

V. Phone/Fax

Practice location:
  • Phone: 509-892-1637
  • Fax: 509-892-3726
Mailing address:
  • Phone: 509-868-0442
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00020276
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: