Provider Demographics
NPI:1548258114
Name:FASSETT, WILLIAM EDMOND (BS PHARM, MBA, PHD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:EDMOND
Last Name:FASSETT
Suffix:
Gender:M
Credentials:BS PHARM, MBA, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2403 W CAROLINA CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99208-8690
Mailing Address - Country:US
Mailing Address - Phone:509-468-4900
Mailing Address - Fax:
Practice Address - Street 1:310 N RIVERPOINT BLVD
Practice Address - Street 2:STE 210C
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-1610
Practice Address - Country:US
Practice Address - Phone:509-358-7666
Practice Address - Fax:509-358-7744
Is Sole Proprietor?:No
Enumeration Date:2005-10-07
Last Update Date:2010-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00008093183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAPHCT.PH.60125044OtherWASHINGTON COLLABORATIVE PRACTICE AGREEMENT