Provider Demographics
NPI:1619293503
Name:SHERWOOD, RICHARD E (RPH)
Entity Type:Individual
Prefix:MR
First Name:RICHARD
Middle Name:E
Last Name:SHERWOOD
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:PO BOX 8097
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-0097
Mailing Address - Country:US
Mailing Address - Phone:509-838-4868
Mailing Address - Fax:
Practice Address - Street 1:2503 S MANITO BLVD
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2453
Practice Address - Country:US
Practice Address - Phone:509-838-4868
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-04-16
Last Update Date:2010-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00007511183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPH00007511OtherWASHINGTON STATE LICENSE