Individual
MR. CLINTON LEE FUNKHOUSER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
5520 N DIVISION ST, SPOKANE, WA 99208-1211
(509) 489-3603
Mailing address
14912 E LONGFELLOW AVE, SPOKANE VALLEY, WA 99216-1326
(509) 928-8936
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
5302032153
MI
183500000X
Pharmacist
Primary
PH00009581
WA
183500000X
Pharmacist
RPH-0009464
OR
Other
Enumeration date
10/13/2005
Last updated
07/08/2007
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