Healthcare Provider Details

I. General information

NPI: 1396811303
Provider Name (Legal Business Name): DONALD L. WOOD RPH
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 W 5TH AVE ATTEN. SHMC ANTICOAGULATION CLINIC
SPOKANE WA
99204-4880
US

IV. Provider business mailing address

104 W 5TH AVE ATTEN. SHMC ANTICOAGULATION CLINIC
SPOKANE WA
99204-4880
US

V. Phone/Fax

Practice location:
  • Phone: 509-474-2232
  • Fax: 509-474-2233
Mailing address:
  • Phone: 509-474-2232
  • Fax: 509-474-2233

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH00010028
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: