Provider Demographics
NPI:1629140348
Name:WHEELER, MEGAN ANN (PHARMD)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:ANN
Last Name:WHEELER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23119 E BROADWAY AVE
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-7506
Mailing Address - Country:US
Mailing Address - Phone:509-343-3411
Mailing Address - Fax:
Practice Address - Street 1:125 S COWLEY ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1500
Practice Address - Country:US
Practice Address - Phone:509-343-3411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-15
Last Update Date:2009-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00041378183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist