Individual
DUC MAI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
19200 N KELSEY ST, MONROE, WA 98272-1431
(360) 794-5555
(360) 805-4797
Mailing address
19200 N KELSEY ST, MONROE, WA 98272-1431
(360) 794-5555
(360) 805-4797
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
IR 60473508
WA
Other
Enumeration date
11/30/2015
Last updated
11/30/2015
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