Individual
COREY VANDENBOOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
10105 224TH ST E, GRAHAM, WA 98338-9190
(253) 847-7634
(253) 847-7635
Mailing address
10105 224TH ST E, GRAHAM, WA 98338-9190
(253) 847-7634
(253) 847-7635
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
00065649
WA
Other
Enumeration date
10/26/2010
Last updated
10/26/2010
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