Individual
JEFFREY BRUCE WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
33702 21ST AVE SW, FEDERAL WAY, WA 98023-7762
(253) 952-0133
Mailing address
30201 18TH AVE SW, FEDERAL WAY, WA 98023-3443
(253) 653-4624
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
00010797
WA
Other
Enumeration date
03/19/2012
Last updated
03/19/2012
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