Individual
JUSTIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
611 31ST AVE SW, PUYALLUP, WA 98373-3723
(253) 445-7100
Mailing address
1915 14TH ST SW, PUYALLUP, WA 98371-7333
(253) 732-6705
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60215209
WA
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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