Individual
MR. EZEKIEL VK DEENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
551 SOUTH MARKET BLVD, CHEHALIS, WA 98532
(360) 748-8801
Mailing address
316 OSO BERRY ST NW, OLYMPIA, WA 98502
(360) 878-9597
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60074866
WA
Other
Enumeration date
05/03/2011
Last updated
05/03/2011
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