Provider Demographics
NPI:1922361880
Name:HOEKSTRA, TAWNIA (PHARM D)
Entity Type:Individual
Prefix:
First Name:TAWNIA
Middle Name:
Last Name:HOEKSTRA
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23309 E DESMET CT
Mailing Address - Street 2:
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-8539
Mailing Address - Country:US
Mailing Address - Phone:509-893-8877
Mailing Address - Fax:
Practice Address - Street 1:13606 E 32ND AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-0113
Practice Address - Country:US
Practice Address - Phone:509-892-3659
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-15
Last Update Date:2012-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00040092183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist