Individual
MRS. JOANNALYN SAN BUENAVENTURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACY TECHNICIAN
Contact information
Practice address
1200 SW 27TH ST, RENTON, WA 98057-2603
(206) 630-7910
(877) 224-4167
Mailing address
2737 DIAMOND ST UNIT A, MILTON, WA 98354-8348
(253) 347-9091
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA00066211
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
360101060763490
PTCB LICENSE
—
01
—
VA00066211
WA PHARMACY TECHNICIAN LICENSE
WA
Enumeration date
08/17/2017
Last updated
06/16/2018
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