Individual
HENRY PETER LUCKEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
14692 179TH AVE SE, MONROE, WA 98272-1198
(360) 794-5555
Mailing address
22711 100TH ST SE, MONROE, WA 98272-9780
(360) 794-9543
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00010210
WA
Other
Enumeration date
12/23/2006
Last updated
07/08/2007
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