Individual
MRS. CLAIRESE DANIEL JORGENSEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
26015 104TH AVE SE, KENT, WA 98030-7647
(253) 850-6480
(253) 850-6498
Mailing address
8615 158TH STREET CT E, PUYALLUP, WA 98375-8932
(253) 445-8724
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA00043245
WA
Other
Enumeration date
02/22/2006
Last updated
07/08/2007
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