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Organization

PACIFIC NORTHWEST SPECIALTY PHARMACY LLC

Active
Other names
Pacific NW Specialty Pharmacy, LLC
Organization subpart
No

Provider details

NPI number
Authorized official
JANET COLEMAN (PRESIDENT/OWNER)
(360) 606-8777
Entity
Organization

Contact information

Practice address
3801 MAIN ST STE A, VANCOUVER, WA 98663-2258
(360) 448-7890
(360) 448-7258
Mailing address
3801 MAIN ST STE A, VANCOUVER, WA 98663-2258
(360) 448-7890
(360) 448-7258

Taxonomy

Speciality
Code
Description
License number
State
333600000X
Pharmacy
3336C0003X
Community/Retail Pharmacy
Primary
3336C0004X
Compounding Pharmacy
PHARCF60285905
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2050038
WA
Enumeration date
07/16/2012
Last updated
02/22/2021
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