Individual
DR. JASON T WICKLUND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
400 E 5TH AVE STE 201, SPOKANE, WA 99202-1334
(509) 838-3588
Mailing address
4305 S PINEGROVE RD, SPOKANE, WA 99223-1204
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00064873
WA
Other
Enumeration date
01/11/2007
Last updated
07/08/2007
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