Provider Demographics
NPI:1639862840
Name:SMITH, KAITLIN LOUISE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KAITLIN
Middle Name:LOUISE
Last Name:SMITH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:KAITLIN
Other - Middle Name:LOUISE
Other - Last Name:KNUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:1111 N BURNS RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-1918
Mailing Address - Country:US
Mailing Address - Phone:509-389-0697
Mailing Address - Fax:
Practice Address - Street 1:1111 N BURNS RD
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-1918
Practice Address - Country:US
Practice Address - Phone:509-389-0697
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-01
Last Update Date:2023-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60147354183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist