Provider Demographics
NPI:1275053068
Name:JOHNSON, LYNDA JOYCE (RPH)
Entity Type:Individual
Prefix:
First Name:LYNDA
Middle Name:JOYCE
Last Name:JOHNSON
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 1:1220 E OVERBLUFF RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-3453
Mailing Address - Country:US
Mailing Address - Phone:509-220-7830
Mailing Address - Fax:509-993-6594
Practice Address - Street 1:2509 E 29TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4803
Practice Address - Country:US
Practice Address - Phone:509-532-9182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-22
Last Update Date:2017-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA00010098183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist