Basic Information
Provider Information
NPI: 1003290941
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KAYSER
FirstName: KATHRYN
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: PHARMD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 203 N WASHINGTON ST
Address2: SUITE 300
City: SPOKANE
State: WA
PostalCode: 992010233
CountryCode: US
TelephoneNumber: 5094448200
FaxNumber: 5094447806
Practice Location
Address1: 3919 N MAPLE ST
Address2:  
City: SPOKANE
State: WA
PostalCode: 992051349
CountryCode: US
TelephoneNumber: 5094448200
FaxNumber: 5094447806
Other Information
ProviderEnumerationDate: 07/09/2015
LastUpdateDate: 12/20/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
183500000XPH60579302WAY Pharmacy Service ProvidersPharmacist 

No ID Information.


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