Provider Demographics
NPI:1487954376
Name:DOHERTY, BRIGITTE F (RPH)
Entity type:Individual
Prefix:
First Name:BRIGITTE
Middle Name:F
Last Name:DOHERTY
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 1:4008 N MOLTER RD
Mailing Address - Street 2:
Mailing Address - City:OTIS ORCHARDS
Mailing Address - State:WA
Mailing Address - Zip Code:99027-8321
Mailing Address - Country:US
Mailing Address - Phone:509-226-2756
Mailing Address - Fax:
Practice Address - Street 1:5707 N FREYA ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99217-6539
Practice Address - Country:US
Practice Address - Phone:509-482-4031
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-26
Last Update Date:2010-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ND3353183500000X
WAPH00020257183500000X
IDP6062183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist