Individual
ELISHA LANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
17520 SR 9, SNOHOMISH, WA 98296-8320
(360) 668-2742
Mailing address
18463 BLUEBERRY LN, APT R101, MONROE, WA 98272-2505
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA 00060399
WA
Other
Enumeration date
08/15/2012
Last updated
10/29/2016
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