Individual
MR. MASTAN RAMPRASAD GANGISETTI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1600 E CHESTNUT AVE, YAKIMA, WA 98901-2174
(509) 248-3855
(509) 452-5203
Mailing address
1600 E CHESTNUT AVE, YAKIMA, WA 98901-2174
(509) 248-3855
(509) 452-5203
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60097582
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH60097582
PHARMACIST LICENSE
WA
Enumeration date
11/13/2014
Last updated
11/13/2014
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