Individual
JENNIFER KANGVAN BAISLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPHT
Contact information
Practice address
1630 S GRAND AVE, PULLMAN, WA 99163-4906
(509) 339-9371
(509) 334-4415
Mailing address
1630 S GRAND AVE, PULLMAN, WA 99163-4906
(509) 339-9371
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA60791279
WA
Other
Enumeration date
05/03/2023
Last updated
05/03/2023
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