Individual
MELISSA ANN CICELSKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
3500 SE 26TH AVE, PORTLAND, OR 97202-2901
(800) 552-1827
Mailing address
PO BOX 635, LA CENTER, WA 98629-0635
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00015938
WA
Other
Enumeration date
10/26/2020
Last updated
10/26/2020
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