Provider Demographics
NPI:1366049041
Name:CARVO, RYAN DAVID (RPH)
Entity type:Individual
Prefix:
First Name:RYAN
Middle Name:DAVID
Last Name:CARVO
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3307 E 24TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99223-3928
Mailing Address - Country:US
Mailing Address - Phone:509-713-0781
Mailing Address - Fax:
Practice Address - Street 1:2509 E 29TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99223-4803
Practice Address - Country:US
Practice Address - Phone:509-532-9182
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-05
Last Update Date:2020-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP9054183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist