Individual
IVY IKEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
205 THREE RIVERS DR, KELSO, WA 98626-3127
(360) 578-7387
Mailing address
205 THREE RIVERS DR, KELSO, WA 98626-3127
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60583327
WA
183500000X
Pharmacist
RPH-0013889
OR
Other
Enumeration date
03/19/2014
Last updated
04/06/2017
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