Individual
ELLIE LOUISE VANDERVERT
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14202 N MARKET ST, MEAD, WA 99021-9524
(509) 242-0201
Mailing address
24907 N PERRY RD, COLBERT, WA 99005-9096
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH61563392
WA
Other
Enumeration date
11/26/2024
Last updated
11/26/2024
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