Healthcare Provider Details

I. General information

NPI: 1477641538
Provider Name (Legal Business Name): DR. AUDRE GARRETT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/11/2006
Last Update Date: 11/08/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 S HAYFORD RD
SPOKANE WA
99224-7023
US

IV. Provider business mailing address

1221 S HAYFORD RD
SPOKANE WA
99224-7023
US

V. Phone/Fax

Practice location:
  • Phone: 509-459-0614
  • Fax: 509-459-0616
Mailing address:
  • Phone: 509-459-0614
  • Fax: 509-459-0616

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License NumberPH0060319
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: