Individual
ADIS CERIC
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5322 CAMELOT DR SW, OLYMPIA, WA 98512-1941
(360) 748-8801
Mailing address
5322 CAMELOT DR SW, OLYMPIA, WA 98512-1941
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH 60584748
WA
Other
Enumeration date
09/28/2015
Last updated
09/28/2015
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