Provider Demographics
NPI:1922883628
Name:DEBESAI, AIDA S (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:AIDA
Middle Name:S
Last Name:DEBESAI
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:N/A
Other - Middle Name:N/A
Other - Last Name:N/A
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:9770 N NEWPORT HWY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1249
Mailing Address - Country:US
Mailing Address - Phone:509-466-7226
Mailing Address - Fax:
Practice Address - Street 1:9770 N NEWPORT HWY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1249
Practice Address - Country:US
Practice Address - Phone:509-466-7226
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-30
Last Update Date:2024-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61452598183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist