Individual
KRISTINE MARIE TANNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
8090 GUIDE MERIDIAN RD, LYNDEN, WA 98264-9210
(360) 354-4284
Mailing address
849 S HILLS DR, BELLINGHAM, WA 98229-6846
(630) 456-3733
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00065062
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH00065062
STATE LICENSE
WA
Enumeration date
05/15/2011
Last updated
05/15/2011
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