Provider Demographics
NPI:1922478254
Name:FRY, CHRISTIAN (PHARMD)
Entity Type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:
Last Name:FRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9212 N COLTON ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1284
Mailing Address - Country:US
Mailing Address - Phone:509-464-2736
Mailing Address - Fax:509-464-4692
Practice Address - Street 1:9212 N COLTON ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1284
Practice Address - Country:US
Practice Address - Phone:509-464-2736
Practice Address - Fax:509-464-4692
Is Sole Proprietor?:Yes
Enumeration Date:2015-09-29
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60557648183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist