Healthcare Provider Details

I. General information

NPI: 1609150770
Provider Name (Legal Business Name): MICHAEL JOSEPH STAMPER PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/06/2011
Last Update Date: 04/16/2024
Certification Date: 04/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2560 NE HOPKINS CT
PULLMAN WA
99163-5622
US

IV. Provider business mailing address

2560 NE HOPKINS CT
PULLMAN WA
99163-5622
US

V. Phone/Fax

Practice location:
  • Phone: 509-338-3800
  • Fax: 509-339-2702
Mailing address:
  • Phone: 509-338-3800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH60153165
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: