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Individual

BRAYDEN BIRKETT POFFENROTH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
2507 W WELLESLEY AVE, SPOKANE, WA 99205-5007
(509) 325-4396
Mailing address
5819 N ELGIN ST, SPOKANE, WA 99205-6933

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
3671634
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3671634
PHARMACIST LICENSE
ID
Enumeration date
11/16/2024
Last updated
11/16/2024
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