Provider Demographics
NPI:1730479346
Name:CROTHERS, ROBERT W (PHARMD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:W
Last Name:CROTHERS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 5TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-1860
Mailing Address - Country:US
Mailing Address - Phone:509-758-8897
Mailing Address - Fax:509-751-9025
Practice Address - Street 1:301 5TH ST
Practice Address - Street 2:
Practice Address - City:CLARKSTON
Practice Address - State:WA
Practice Address - Zip Code:99403-1860
Practice Address - Country:US
Practice Address - Phone:509-758-8897
Practice Address - Fax:509-751-9025
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-15
Last Update Date:2020-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00049508183500000X, 1835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
No183500000XPharmacy Service ProvidersPharmacist