Individual
CARISSA LOU HORNICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6619 132ND AVE NE, KIRKLAND, WA 98033-8627
(425) 881-5544
Mailing address
866 4TH AVE NE, ISSAQUAH, WA 98029-5402
(425) 516-4013
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA 00068679
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VA 00068679
WASHINGTON STATE DEPARTMENT OF HEALTH
WA
Enumeration date
09/22/2011
Last updated
09/22/2011
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