Healthcare Provider Details

I. General information

NPI: 1952331514
Provider Name (Legal Business Name): LINDA COLLEEN NELSON PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4815 N ASSEMBLY ST
SPOKANE WA
99205-6185
US

IV. Provider business mailing address

4716 S HOGAN ST
SPOKANE WA
99223-6543
US

V. Phone/Fax

Practice location:
  • Phone: 509-434-7719
  • Fax: 509-434-7130
Mailing address:
  • Phone: 509-448-8787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P1200X
TaxonomyPharmacotherapy Pharmacist
License Number00039363
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: