Individual
D'ANN RAE YORK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH, PHARM. D.
Contact information
Practice address
414 N MAIN ST, MOSCOW, ID 83843-2631
(208) 882-6076
Mailing address
414 N MAIN ST, MOSCOW, ID 83843-2631
(208) 882-6076
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6701
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P6701
IDAHO STATE BOARD OF PHARMACY
ID
Enumeration date
08/15/2012
Last updated
08/15/2012
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