Provider Demographics
NPI:1790851228
Name:KITTAMS, ROBERT CHARLES (RPH)
Entity Type:Individual
Prefix:MR
First Name:ROBERT
Middle Name:CHARLES
Last Name:KITTAMS
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3520 S MOUNT VERNON ST
Mailing Address - Street 2:UNIT 5
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-4697
Mailing Address - Country:US
Mailing Address - Phone:509-532-0920
Mailing Address - Fax:
Practice Address - Street 1:2320 S SALNAVE ROAD
Practice Address - Street 2:LAKELAND VILLAGE PHARMACY DEPT.
Practice Address - City:MEDICAL LAKE
Practice Address - State:WA
Practice Address - Zip Code:99022-0200
Practice Address - Country:US
Practice Address - Phone:509-299-1976
Practice Address - Fax:509-299-1967
Is Sole Proprietor?:No
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00019483183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist