Provider Demographics
NPI:1144381716
Name:WENDE, NATHAN S (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:S
Last Name:WENDE
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:104 S FREYA ST STE 225
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-4887
Mailing Address - Country:US
Mailing Address - Phone:509-343-5134
Mailing Address - Fax:509-343-5199
Practice Address - Street 1:104 S FREYA ST STE 225
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-4887
Practice Address - Country:US
Practice Address - Phone:509-343-5134
Practice Address - Fax:509-343-5199
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00045533183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist