Individual
MCKNZY DEANNA MILLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5201 CAPITOL BLVD SW, TUMWATER, WA 98501-4418
(360) 943-4043
Mailing address
1515 BLOOMHARDT RD, RAYMOND, WA 98577-9670
(360) 581-3289
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60754024
WA
Other
Enumeration date
04/16/2020
Last updated
04/16/2020
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