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Individual

ANTHONY RAY LIEDTKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RPH

Contact information

Practice address
9600 VETERANS DR SW, TACOMA, WA 98493-0003
(253) 583-1177
Mailing address
6517 80TH ST SW, LAKEWOOD, WA 98499-2506
(253) 582-4108

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00011725
WA

Other

Enumeration date
10/12/2006
Last updated
07/08/2007
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