=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487721569
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SARAH INEZ MARRINAN DOCTOR OF PHARMACY
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 11/30/2006
-----------------------------------------------------
Last Update Date | 09/08/2016
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 101 W 8TH AVE
-----------------------------------------------------
City | SPOKANE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99204-2307
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-474-3244
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 6911 N IDAHO RD
-----------------------------------------------------
City | NEWMAN LAKE
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 99025-9554
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 509-954-6253
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PH00041699
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------