Individual
DOMINIQUE DE LA PENA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
8862 161ST AVE NE, REDMOND, WA 98052-7553
(425) 883-9532
Mailing address
1923 S ORCAS ST, SEATTLE, WA 98108-2928
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
61296477
PHARMACY TECH
—
Enumeration date
12/20/2022
Last updated
12/20/2022
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