Organization
MIKES EASTSIDE DRUGS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MICHAEL GRAEFF B.S. PHARMACY (PRES)
(360) 694-0800
Entity
Organization
Contact information
Practice address
8506 E MILL PLAIN BLVD, VANCOUVER, WA 98664-2011
(360) 694-0800
Mailing address
8506 E MILL PLAIN BLVD, VANCOUVER, WA 98664-2011
(360) 694-0800
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
CF00001931
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6082606
—
WA
Enumeration date
04/27/2007
Last updated
08/22/2020
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