Individual
BENJAMIN ROBERT LARSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM D
Contact information
Practice address
106 1ST ST S, YELM, WA 98597-7700
(360) 458-8467
Mailing address
PO BOX 3097, 11840 BALD HILLS RD SE, YELM, WA 98597
(360) 458-0634
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00055787
WA
Other
Enumeration date
10/17/2008
Last updated
10/17/2008
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