Individual
DR. CRYSTAL ANN SPANG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
11619 ISLAND AVE, LA GRANDE, OR 97850-8459
(541) 963-5460
Mailing address
74377 BRAMLETT LN, WALLOWA, OR 97885-8217
(541) 969-6767
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
P9693
ID
183500000X
Pharmacist
PH61192040
WA
183500000X
Pharmacist
Primary
RPH-0018553
OR
390200000X
Student in an Organized Health Care Education/Training Program
0000000
OR
Other
Enumeration date
05/13/2021
Last updated
12/26/2024
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