Provider Demographics
NPI:1124660675
Name:RUSCH, JOANNA RUTH (PHARMD)
Entity type:Individual
Prefix:
First Name:JOANNA
Middle Name:RUTH
Last Name:RUSCH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5312 N GREENWOOD BLVD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99205-6042
Mailing Address - Country:US
Mailing Address - Phone:734-883-2256
Mailing Address - Fax:
Practice Address - Street 1:10102 E KNOX AVE STE 400
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4146
Practice Address - Country:US
Practice Address - Phone:425-251-6335
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-16
Last Update Date:2019-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60868678183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist