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Individual
JEFFREY MANGUM
Active
Individual
JEFFREY MANGUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
PH00017370
WA
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
RPH-0013850
OR
Other
Enumeration date
09/13/2011
Last updated
12/31/2015
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