MEDICARE: MRS. TANYA LYNN HAMILTON RPH

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	PH00017616	WA
2	183500000X	Pharmacist	P6987	ID
3	183500000X	Pharmacist	RPH-0012217	OR

General Provider Information

NPI Number	:	1699214734
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. TANYA LYNN HAMILTON RPH

Provider Business Mailing Address
First Line	:	2114 N PINES RD
Second Line	:	SUITES 4 & 5
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-4757
Country	:	US
Telephone Number	:	509-893-1011
Fax Number	:	800-865-5025

Provider Business Practice Location Address
First Line	:	2114 N PINES RD
Second Line	:	SUITES 4 & 5
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-4757
Country	:	US
Telephone Number	:	509-893-1011
Fax Number	:	800-865-5025

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

Provider Enumeration Date	:	02/22/2017
Last Update Date	:	02/22/2017

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