Provider Demographics
NPI:1447510995
Name:RAMSRUD, AUTUMN LYNN (PHARMD)
Entity type:Individual
Prefix:
First Name:AUTUMN
Middle Name:LYNN
Last Name:RAMSRUD
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:528 E SPOKANE FALLS BLVD STE 110
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-5050
Mailing Address - Country:US
Mailing Address - Phone:509-343-6252
Mailing Address - Fax:509-343-6251
Practice Address - Street 1:528 E SPOKANE FALLS BLVD STE 110
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5050
Practice Address - Country:US
Practice Address - Phone:509-343-6252
Practice Address - Fax:509-343-6251
Is Sole Proprietor?:No
Enumeration Date:2012-05-17
Last Update Date:2012-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60244461183500000X
ORRPH-0013006183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist