Healthcare Provider Details

I. General information

NPI: 1558525584
Provider Name (Legal Business Name): RACHAEL R COLLER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/18/2008
Last Update Date: 02/05/2024
Certification Date: 02/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 N ASSEMBLY ST
SPOKANE WA
99205-6185
US

IV. Provider business mailing address

4536 ESTRELLA AVE
SAN DIEGO CA
92115-3241
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-7000
  • Fax:
Mailing address:
  • Phone: 503-360-2200
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number26022885A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number65236
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number65236
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: