Provider Demographics
NPI:1457577272
Name:HEISTER, ANGELA M (PHARMACIST)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:M
Last Name:HEISTER
Suffix:
Gender:F
Credentials:PHARMACIST
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:M
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:12020 N NEWPORT HWY
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99218-1655
Mailing Address - Country:US
Mailing Address - Phone:509-466-3315
Mailing Address - Fax:509-468-9101
Practice Address - Street 1:12020 N NEWPORT HWY
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99218-1655
Practice Address - Country:US
Practice Address - Phone:509-466-3315
Practice Address - Fax:509-468-9101
Is Sole Proprietor?:No
Enumeration Date:2007-04-18
Last Update Date:2021-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00019258183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist