Provider Demographics
NPI:1477641538
Name:GARRETT, AUDRE
Entity Type:Individual
Prefix:DR
First Name:AUDRE
Middle Name:
Last Name:GARRETT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1221 S HAYFORD RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-7023
Mailing Address - Country:US
Mailing Address - Phone:509-459-0614
Mailing Address - Fax:509-459-0616
Practice Address - Street 1:1221 S HAYFORD RD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-7023
Practice Address - Country:US
Practice Address - Phone:509-459-0614
Practice Address - Fax:509-459-0616
Is Sole Proprietor?:No
Enumeration Date:2006-10-11
Last Update Date:2016-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00603191835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy