Healthcare Provider Details

I. General information

NPI: 1871418582
Provider Name (Legal Business Name): DAKOTA GAMBLE
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5601 E SPRAGUE AVE
SPOKANE VALLEY WA
99212-0826
US

IV. Provider business mailing address

5601 E SPRAGUE AVE
SPOKANE VALLEY WA
99212-0826
US

V. Phone/Fax

Practice location:
  • Phone: 509-842-0002
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH70125259
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: