Individual
DYLAN AVERY GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
510 W 1ST AVE, TOPPENISH, WA 98948-1564
(509) 865-5600
Mailing address
510 W 1ST AVE, TOPPENISH, WA 98948-1564
(509) 865-5600
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00040651
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH 00040651
STATE PHARMACIST LICENSE
WA
Enumeration date
02/10/2012
Last updated
08/19/2024
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