Provider Demographics
NPI:1467927913
Name:SANDERS, TYLER S (RPH)
Entity Type:Individual
Prefix:DR
First Name:TYLER
Middle Name:S
Last Name:SANDERS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99212-0826
Mailing Address - Country:US
Mailing Address - Phone:509-842-0002
Mailing Address - Fax:
Practice Address - Street 1:5601 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99212-0826
Practice Address - Country:US
Practice Address - Phone:509-842-0002
Practice Address - Fax:509-842-0009
Is Sole Proprietor?:Yes
Enumeration Date:2018-10-11
Last Update Date:2022-06-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60867743183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist