Individual
LUIS MANUEL ANGELES JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
405 KILLION CT NW, YELM, WA 98597-9411
(865) 385-4072
Mailing address
18709 BONHAM AVE, CARSON, CA 90746-2138
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
0017480
OR
183500000X
Pharmacist
Primary
61022246
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH61022246
PHARMACIST LICENSE
WA
01
—
RPH-0017480
PHARMACIST LICENSE
OR
Enumeration date
04/03/2020
Last updated
04/03/2020
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