Provider Demographics
NPI:1720754468
Name:ROCA, MELINDA (PHARMD)
Entity Type:Individual
Prefix:
First Name:MELINDA
Middle Name:
Last Name:ROCA
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MELINDA, MINDY
Other - Middle Name:
Other - Last Name:TIEGS, ROCA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD
Mailing Address - Street 1:4001 N COOK ST STE 900
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99207-5879
Mailing Address - Country:US
Mailing Address - Phone:509-483-3427
Mailing Address - Fax:
Practice Address - Street 1:4001 N COOK ST STE 900
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-5879
Practice Address - Country:US
Practice Address - Phone:509-483-3427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-08-22
Last Update Date:2023-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP9425183500000X
WAPH61175494183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist