MEDICARE: CRYSTAL PADA LEWIS PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	IR60875973	WA

General Provider Information

NPI Number	:	1073257861
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CRYSTAL PADA LEWIS PHARMD

Provider Business Mailing Address
First Line	:	1303 W 13TH AVE APT 1
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99204-4069
Country	:	US
Telephone Number	:	253-777-8955
Fax Number	:

Provider Business Practice Location Address
First Line	:	11 GRANT RD
Second Line	:
City	:	EAST WENATCHEE
State	:	WA
Zip	:	98802-5328
Country	:	US
Telephone Number	:	509-881-2899
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/26/2022
Last Update Date	:	04/26/2022

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