Individual
MR. ELLERY RYDER DIXON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
STUDENT PHARMACIST
Contact information
Practice address
2425 DIAMOND ST, MILTON, WA 98354-9310
(253) 922-6242
Mailing address
2425 DIAMOND ST, MILTON, WA 98354-9310
(253) 922-6242
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
IR 60121008
WA
Other
Enumeration date
06/07/2016
Last updated
06/07/2016
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