Healthcare Provider Details

I. General information

NPI: 1962884239
Provider Name (Legal Business Name): VACCINES 2U
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/23/2015
Last Update Date: 06/23/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12418 E SALTESE AVE
SPOKANE VALLEY WA
99216-0357
US

IV. Provider business mailing address

12418 E SALTESE AVE
SPOKANE VALLEY WA
99216-0357
US

V. Phone/Fax

Practice location:
  • Phone: 509-475-1347
  • Fax:
Mailing address:
  • Phone: 509-475-1347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QH0100X
TaxonomyHealth Service Clinic/Center
License NumberPHHC.FX.60543314
License Number StateWA

VIII. Authorized Official

Name: JILL HARVEY
Title or Position: OWNER
Credential: PHARMD
Phone: 509-475-1347