Individual
JAMIE LEE PARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
700 W IRONWOOD DR, COEUR D ALENE, ID 83814-2656
(208) 625-5688
(208) 625-5687
Mailing address
11411 N TRAFALGAR ST, HAYDEN, ID 83835-9134
(208) 215-9295
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P6063
ID
Other
Enumeration date
08/21/2017
Last updated
08/21/2017
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