Provider Demographics
NPI:1043837354
Name:DEATS, COURTNEY CHRISTINE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:CHRISTINE
Last Name:DEATS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:802 CITRA AVE
Mailing Address - Street 2:
Mailing Address - City:MOXEE
Mailing Address - State:WA
Mailing Address - Zip Code:98936-8814
Mailing Address - Country:US
Mailing Address - Phone:509-831-5627
Mailing Address - Fax:
Practice Address - Street 1:119 E 3RD AVE
Practice Address - Street 2:
Practice Address - City:SELAH
Practice Address - State:WA
Practice Address - Zip Code:98942-1498
Practice Address - Country:US
Practice Address - Phone:509-697-6125
Practice Address - Fax:509-697-9399
Is Sole Proprietor?:No
Enumeration Date:2020-07-02
Last Update Date:2020-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60945602183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist