Individual
GLEN COREY PIERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
R.PH.
Contact information
Practice address
13603 BANDIX RD SE, OLALLA, WA 98359-9469
(253) 302-9024
Mailing address
13603 BANDIX RD SE, OLALLA, WA 98359-9469
(253) 302-9024
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00015079
WA
1835P1200X
Pharmacotherapy Pharmacist
PH00015079
WA
Other
Enumeration date
03/28/2008
Last updated
03/28/2008
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