Individual
KENNETH BAULEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CPHT
Contact information
Practice address
13511 SE 3RD WAY, VANCOUVER, WA 98684-6990
(360) 885-0839
Mailing address
306 SE 161ST AVE, VANCOUVER, WA 98684-9544
(360) 771-3817
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA61378737
WA
Other
Enumeration date
04/10/2023
Last updated
04/10/2023
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