Healthcare Provider Details

I. General information

NPI: 1659097939
Provider Name (Legal Business Name): COLE WREN PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2022
Last Update Date: 10/18/2022
Certification Date: 10/18/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1724 W FRANCIS AVE
SPOKANE WA
99205-6889
US

IV. Provider business mailing address

4224 N OAK ST
SPOKANE WA
99205-1426
US

V. Phone/Fax

Practice location:
  • Phone: 509-325-3431
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH61308051
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: