Healthcare Provider Details

I. General information

NPI: 1225302490
Provider Name (Legal Business Name): DIANE ELIZABETH EVERETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/06/2012
Last Update Date: 05/28/2026
Certification Date: 05/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15609 E SPRAGUE AVE
SPOKANE VALLEY WA
99037-5003
US

IV. Provider business mailing address

15609 E SPRAGUE AVE
SPOKANE VALLEY WA
99037-8901
US

V. Phone/Fax

Practice location:
  • Phone: 509-921-5383
  • Fax: 509-921-5377
Mailing address:
  • Phone: 509-921-5383
  • Fax: 509-921-5377

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH00017651
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: