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Individual

DR. LUKE AARON VANDER WEIDE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
16811 SE MCGILLIVRAY BLVD, #101, VANCOUVER, WA 98683-3404
(360) 750-3206
Mailing address
16811 SE MCGILLIVRAY BLVD, #101, VANCOUVER, WA 98683-3404
(360) 750-3206

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
03234108
OH
1835P2201X
Ambulatory Care Pharmacist
Primary
PH60561814
WA

Other

Enumeration date
04/01/2015
Last updated
11/02/2016
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