Provider Demographics
NPI:1427359546
Name:COOPERSMITH, CONSTANCE LYNN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:CONSTANCE
Middle Name:LYNN
Last Name:COOPERSMITH
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 1:3919 N MARKET ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-5813
Mailing Address - Country:US
Mailing Address - Phone:509-482-3480
Mailing Address - Fax:
Practice Address - Street 1:3919 N MARKET ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5813
Practice Address - Country:US
Practice Address - Phone:509-482-3480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-11-04
Last Update Date:2010-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009221183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist