Healthcare Provider Details

I. General information

NPI: 1689588808
Provider Name (Legal Business Name): NATHAN TAYLOR PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2026
Last Update Date: 10/02/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5633 N LIDGERWOOD ST
SPOKANE WA
99208-1224
US

IV. Provider business mailing address

5633 N LIDGERWOOD ST
SPOKANE WA
99208-1224
US

V. Phone/Fax

Practice location:
  • Phone: 509-482-2261
  • Fax:
Mailing address:
  • Phone: 509-482-2261
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPHRM.PH.70135827
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: