Provider Demographics
NPI:1528322138
Name:SCHWAB, GRAIG V (RPH)
Entity type:Individual
Prefix:
First Name:GRAIG
Middle Name:V
Last Name:SCHWAB
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 757
Mailing Address - Street 2:
Mailing Address - City:ELLENSBURG
Mailing Address - State:WA
Mailing Address - Zip Code:98926-1921
Mailing Address - Country:US
Mailing Address - Phone:509-968-9545
Mailing Address - Fax:509-968-9546
Practice Address - Street 1:108B E. RAILROAD AVE
Practice Address - Street 2:
Practice Address - City:KITTITAS
Practice Address - State:WA
Practice Address - Zip Code:98934
Practice Address - Country:US
Practice Address - Phone:509-968-9545
Practice Address - Fax:509-968-9546
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-28
Last Update Date:2012-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011482183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist