Individual
MRS. LARA PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1206 N 40TH AVE, YAKIMA, WA 98908-9456
(509) 576-6833
Mailing address
120 ECHO GLENN PL, YAKIMA, WA 98908-8815
(509) 388-8643
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
00059649
WA
Other
Enumeration date
12/20/2012
Last updated
12/20/2012
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