Provider Demographics
NPI:1780667352
Name:BUXTON, JODIANNE
Entity Type:Individual
Prefix:MS
First Name:JODIANNE
Middle Name:
Last Name:BUXTON
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:JODIANNE
Other - Middle Name:
Other - Last Name:WAGNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3625 E NORWOOD RD
Mailing Address - Street 2:
Mailing Address - City:COLBERT
Mailing Address - State:WA
Mailing Address - Zip Code:99005-9764
Mailing Address - Country:US
Mailing Address - Phone:509-723-5498
Mailing Address - Fax:
Practice Address - Street 1:46 E ROWAN AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-1232
Practice Address - Country:US
Practice Address - Phone:509-482-3057
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-28
Last Update Date:2021-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000599511835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy