Provider Demographics
NPI:1639551534
Name:WEVERS, KYNDRA (PHARMD)
Entity Type:Individual
Prefix:MRS
First Name:KYNDRA
Middle Name:
Last Name:WEVERS
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 1:12414 E SPRAGUE AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-0722
Mailing Address - Country:US
Mailing Address - Phone:509-924-1222
Mailing Address - Fax:509-922-6411
Practice Address - Street 1:12414 E SPRAGUE AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0722
Practice Address - Country:US
Practice Address - Phone:509-924-1222
Practice Address - Fax:509-922-6411
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-26
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040002183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist