NPI 1033635180

Jamie Lee Park, PHARMD

Practitioner Pharmacist Coeur D Alene, ID

Practice location

Address: 700 W Ironwood Dr, Coeur D Alene, ID 83814-2656
Phone: (208) 625-5688
Fax: (208) 625-5687
Mailing address: 11411 N Trafalgar St, Hayden, ID 83835-9134

Registered specialties

Pharmacist Primary

Pharmacy Service Providers Taxonomy 183500000X Licence P6063 (ID)

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Registry record

NPI: 1033635180
Entity type: Individual
Sex (as registered): Female
NPI issued: 21 Aug 2017
Record last updated: 21 Aug 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.