Provider Demographics
NPI:1982661138
Name:GOROSKI, AMIE (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:AMIE
Middle Name:
Last Name:GOROSKI
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:MOXEE
Mailing Address - State:WA
Mailing Address - Zip Code:98936-0497
Mailing Address - Country:US
Mailing Address - Phone:509-995-9059
Mailing Address - Fax:
Practice Address - Street 1:8201 BEAUCHENE RD
Practice Address - Street 2:
Practice Address - City:MOXEE
Practice Address - State:WA
Practice Address - Zip Code:98936-9452
Practice Address - Country:US
Practice Address - Phone:509-995-9059
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-28
Last Update Date:2008-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1402183500000X
MT4369183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist