Provider Demographics
NPI:1841339959
Name:RUNDQUIST, ANN CHRISTINE (RPH)
Entity type:Individual
Prefix:MRS
First Name:ANN
Middle Name:CHRISTINE
Last Name:RUNDQUIST
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:ANN
Other - Middle Name:CHRISTINE
Other - Last Name:RUNDQUIST
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:1909 S STEVENS ST
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-2056
Mailing Address - Country:US
Mailing Address - Phone:509-624-7203
Mailing Address - Fax:
Practice Address - Street 1:1909 S STEVENS ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99203-2056
Practice Address - Country:US
Practice Address - Phone:509-624-7203
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-05
Last Update Date:2014-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009705183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist