Individual
GLEN MORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2521 MAIN ST, VANCOUVER, WA 98660-2649
(360) 693-2524
Mailing address
2521 MAIN ST, VANCOUVER, WA 98660-2649
(360) 693-2524
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00065975
WA
Other
Enumeration date
11/23/2011
Last updated
11/23/2011
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