Provider Demographics
NPI:1568674414
Name:MONROE, COLLEEN KIRSTEN (RPH)
Entity Type:Individual
Prefix:MRS
First Name:COLLEEN
Middle Name:KIRSTEN
Last Name:MONROE
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 1:627 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1946
Mailing Address - Country:US
Mailing Address - Phone:509-624-3237
Mailing Address - Fax:
Practice Address - Street 1:5601 E SPRAGUE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212
Practice Address - Country:US
Practice Address - Phone:509-842-0002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-05-04
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00017802183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist