Healthcare Provider Details

I. General information

NPI: 1326353814
Provider Name (Legal Business Name): STEVEN PATRICK GOODNER RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/10/2010
Last Update Date: 08/10/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 S COWLEY ST
SPOKANE WA
99202-1330
US

IV. Provider business mailing address

3107 S DIVISION ST
SPOKANE WA
99203-1744
US

V. Phone/Fax

Practice location:
  • Phone: 509-473-6008
  • Fax:
Mailing address:
  • Phone: 509-747-0201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberPH00009121
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: