Individual
JULIE RIDEWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3711 88TH ST NE, MARYSVILLE, WA 98270-7214
(360) 530-7761
(360) 530-7795
Mailing address
3711 88TH ST NE, MARYSVILLE, WA 98270-7214
(360) 530-7761
(360) 530-7795
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00017126
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH00017126
STATE PHARMACIST LICENSE
WA
Enumeration date
10/14/2014
Last updated
10/14/2014
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