Individual
MARK COBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
604 N 5TH AVE, SANDPOINT, ID 83864-1520
(208) 263-1408
(208) 265-8784
Mailing address
604 N 5TH AVE, SANDPOINT, ID 83864-1520
(208) 263-1408
(208) 265-8784
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P3991
ID
1835G0303X
Geriatric Pharmacist
PH00009889
WA
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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