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General NPI Number Information
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NPI Number | 1790851228
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Entity Type | Individual
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Provider Name | ROBERT CHARLES KITTAMS RPH.
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Gender | Male
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Dates
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Enumeration Date | 11/27/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 2320 S SALNAVE ROAD LAKELAND VILLAGE PHARMACY DEPT.
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City | MEDICAL LAKE
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State | WA
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Zip | 99022-0200
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Country | US
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Telephone | 509-299-1976
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Fax | 509-299-1967
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Provider Business Mailing Address
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Address Line | 3520 S MOUNT VERNON ST UNIT 5
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City | SPOKANE
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State | WA
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Zip | 99223-4697
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Country | US
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Telephone | 509-532-0920
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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 | PH00019483
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License Number State | WA
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