Provider Demographics
NPI:1427321330
Name:KOENIG, KAREN K (RPH)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:K
Last Name:KOENIG
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:560 W KATHLEEN AVE
Mailing Address - Street 2:
Mailing Address - City:COEUR D ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83815-8392
Mailing Address - Country:US
Mailing Address - Phone:208-665-4733
Mailing Address - Fax:208-665-4727
Practice Address - Street 1:560 W KATHLEEN AVE
Practice Address - Street 2:
Practice Address - City:COEUR D ALENE
Practice Address - State:ID
Practice Address - Zip Code:83815-8392
Practice Address - Country:US
Practice Address - Phone:208-665-4733
Practice Address - Fax:208-665-4727
Is Sole Proprietor?:No
Enumeration Date:2012-02-23
Last Update Date:2012-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP5041183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist