Individual
KATLIN MAY CICCHETTI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
121 W NEIDER AVE, COEUR D ALENE, ID 83815-9300
(208) 765-4410
(208) 765-0451
Mailing address
13198 N TELLURIDE LOOP, HAYDEN, ID 83835-3308
(509) 855-2351
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P7950
ID
183500000X
Pharmacist
PH60749814
WA
Other
Enumeration date
08/25/2017
Last updated
12/11/2020
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