Healthcare Provider Details

I. General information

NPI: 1043143373
Provider Name (Legal Business Name): CHARLES OPOKU
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

9212 N COLTON ST
SPOKANE WA
99218-1284
US

IV. Provider business mailing address

4120 W OLYMPIC AVE
SPOKANE WA
99205-6148
US

V. Phone/Fax

Practice location:
  • Phone: 509-464-2736
  • Fax: 509-464-2738
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRM.PH.61580963
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: