Individual
MARY THIBODEAU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
700 W IRONWOOD DR STE 228, COEUR D ALENE, ID 83814-4473
(208) 625-5672
(208) 625-6488
Mailing address
700 W IRONWOOD DR STE 228, COEUR D ALENE, ID 83814-4473
(208) 625-5672
(208) 625-6488
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
P8107
ID
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PH60020486
WA
Other
Enumeration date
08/03/2015
Last updated
09/17/2025
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