Individual
LEAR ANTHONY WICKENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
800 6TH ST, CLARKSTON, WA 99403-2013
(509) 758-2565
(509) 758-2151
Mailing address
800 6TH ST, CLARKSTON, WA 99403-2013
(509) 758-2565
(509) 758-2151
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00018158
WA
Other
Enumeration date
08/29/2012
Last updated
08/29/2012
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