Individual
MR. RYAN WESLEY GIBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
550 W HONEYSUCKLE AVE, HAYDEN, ID 83835-6042
(208) 209-4081
(208) 209-4057
Mailing address
809 W SPOFFORD AVE APT 6, SPOKANE, WA 99205-4666
(208) 691-3339
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
I63666
ID
183500000X
Pharmacist
IR60900576
WA
Other
Enumeration date
03/29/2020
Last updated
07/14/2023
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