Basic Information
| Provider Information | |||||||||
| NPI: | 1699174318 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | CHAFFEE | ||||||||
| FirstName: | PHILIP | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | MR. | ||||||||
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| Credential: | R.PH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2301 W WELLESLEY ST | ||||||||
| Address2: | WALMART PHARMACY | ||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992050000 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093272015 | ||||||||
| FaxNumber: | 5093272154 | ||||||||
| Practice Location | |||||||||
| Address1: | 2301 W WELLESLEY AVE | ||||||||
| Address2: | WALMART PHARMACY | ||||||||
| City: | SPOKANE | ||||||||
| State: | WA | ||||||||
| PostalCode: | 992055004 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5093272015 | ||||||||
| FaxNumber: | 5093272154 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 08/19/2014 | ||||||||
| LastUpdateDate: | 08/19/2014 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 183500000X | PH00041658 | WA | Y | Pharmacy Service Providers | Pharmacist |
No ID Information.