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General NPI Number Information
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NPI Number | 1801017579
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Entity Type | Individual
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Provider Name | LANAE L WIATER PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 12/06/2018
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Provider Practice Location Address
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Address Line | 5840 N DIVISION ST
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City | SPOKANE
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State | WA
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Zip | 99208-1207
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Country | US
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Telephone | 509-489-6010
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Fax |
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Provider Business Mailing Address
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Address Line | 47738 SUNSET HIGHWAY RD E
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City | DAVENPORT
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State | WA
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Zip | 99122-9565
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Country | US
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Telephone | 509-263-2440
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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 | 0009315
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License Number State | OR
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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 | 00051589
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License Number State | WA
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