MEDICARE: PAMELA ANN EATON

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	PH60424939	WA

General Provider Information

NPI Number	:	1780150771
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PAMELA ANN EATON

Provider Business Mailing Address
First Line	:	3262 N WOODFORD ST
Second Line	:
City	:	POST FALLS
State	:	ID
Zip	:	83854-7882
Country	:	US
Telephone Number	:	775-527-0911
Fax Number	:

Provider Business Practice Location Address
First Line	:	2114 N PINES RD
Second Line	:
City	:	SPOKANE VALLEY
State	:	WA
Zip	:	99206-4757
Country	:	US
Telephone Number	:	509-893-1011
Fax Number	:	509-893-1392

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

Provider Enumeration Date	:	10/17/2018
Last Update Date	:	10/17/2018

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Directions to “ PAMELA ANN EATON ” Practice Location

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