Provider Demographics
NPI:1336418599
Name:GERDE, KAREN DIANE (PHARMD)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:DIANE
Last Name:GERDE
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 1:528 E SPOKANE FALLS BLVD
Mailing Address - Street 2:SUITE #110
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-5081
Mailing Address - Country:US
Mailing Address - Phone:509-343-6252
Mailing Address - Fax:509-343-6251
Practice Address - Street 1:528 E SPOKANE FALLS BLVD
Practice Address - Street 2:SUITE #110
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5081
Practice Address - Country:US
Practice Address - Phone:509-343-6252
Practice Address - Fax:509-343-6251
Is Sole Proprietor?:No
Enumeration Date:2011-12-16
Last Update Date:2014-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60223840183500000X
IDP6616183500000X
IDCS18095183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist