Provider Demographics
NPI:1033466867
Name:RODGERS, SANDRA ELAINE (RPH)
Entity Type:Individual
Prefix:
First Name:SANDRA
Middle Name:ELAINE
Last Name:RODGERS
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3310 E TARA DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-7241
Mailing Address - Country:US
Mailing Address - Phone:509-448-3974
Mailing Address - Fax:
Practice Address - Street 1:400 S THOR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5075
Practice Address - Country:US
Practice Address - Phone:509-532-4033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-10
Last Update Date:2017-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00014334183500000X
ORRPH-00156331835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist