Provider Demographics
NPI:1831183151
Name:OSTMAN, MELANIE SARA (RPH, CGP)
Entity type:Individual
Prefix:
First Name:MELANIE
Middle Name:SARA
Last Name:OSTMAN
Suffix:
Gender:F
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2607 S TIMBERLANE DR
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99037-9059
Mailing Address - Country:US
Mailing Address - Phone:509-891-8593
Mailing Address - Fax:509-489-4334
Practice Address - Street 1:3704 N NEVADA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99207-2968
Practice Address - Country:US
Practice Address - Phone:509-489-4500
Practice Address - Fax:509-489-4334
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00042666183500000X
WAPH0004266183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist