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General NPI Number Information
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NPI Number | 1720290257
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Entity Type | Individual
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Provider Name | VICKI GAIL DAVIS RPH
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1904 19TH AVE
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City | LEWISTON
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State | ID
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Zip | 83501
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Country | US
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Telephone | 208-743-9127
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Fax | 208-743-4777
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Provider Business Mailing Address
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Address Line | 2178 23RD ST
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City | CLARKSTON
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State | WA
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Zip | 99403
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Country | US
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Telephone | 509-751-0114
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | P5631
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License Number State | ID
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Taxonomy #2
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 13219
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License Number State | CO
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Taxonomy #3
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 5291
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License Number State | NM
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