Individual
KENNETH FILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
931 S MARKET BLVD, CHEHALIS, WA 98532-3423
(724) 977-8173
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH61064620
WA
Other
Enumeration date
09/03/2019
Last updated
07/23/2020
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