Provider Demographics
NPI:1841589108
Name:MUNTER, GREGORY K (RPH)
Entity Type:Individual
Prefix:
First Name:GREGORY
Middle Name:K
Last Name:MUNTER
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 1:5520 N DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-1211
Mailing Address - Country:US
Mailing Address - Phone:509-489-6010
Mailing Address - Fax:509-483-6526
Practice Address - Street 1:5415 N SHANE CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-3301
Practice Address - Country:US
Practice Address - Phone:509-926-8434
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-06
Last Update Date:2011-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009480183500000X
IDP5884183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist