Healthcare Provider Details

I. General information

NPI: 1285691741
Provider Name (Legal Business Name): MYRON HIGEL RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 04/27/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3704 N NEVADA ST
SPOKANE WA
99207-2968
US

IV. Provider business mailing address

6323 S MORAN DR
SPOKANE WA
99223-6944
US

V. Phone/Fax

Practice location:
  • Phone: 509-489-4500
  • Fax:
Mailing address:
  • Phone: 509-489-4500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH00018000
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: