Provider Demographics
NPI:1699214734
Name:HAMILTON, TANYA LYNN (RPH)
Entity type:Individual
Prefix:MRS
First Name:TANYA
Middle Name:LYNN
Last Name:HAMILTON
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 1:2114 N PINES RD
Mailing Address - Street 2:SUITES 4 & 5
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99206-4757
Mailing Address - Country:US
Mailing Address - Phone:509-893-1011
Mailing Address - Fax:800-865-5025
Practice Address - Street 1:2114 N PINES RD
Practice Address - Street 2:SUITES 4 & 5
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99206-4757
Practice Address - Country:US
Practice Address - Phone:509-893-1011
Practice Address - Fax:800-865-5025
Is Sole Proprietor?:No
Enumeration Date:2017-02-22
Last Update Date:2017-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00017616183500000X
IDP6987183500000X
ORRPH-0012217183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist