Individual
LISA MARIE HAACKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARMACY TECHNIEIAN
Contact information
Practice address
11912 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98662
(360) 944-8368
(360) 944-6555
Mailing address
11912 NE FOURTH PLAIN BLVD, VANCOUVER, WA 98662
(360) 944-8368
(360) 944-6555
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA 00062276
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VA 00062276
WASHINGTON STATE
WA
Enumeration date
03/01/2012
Last updated
03/01/2012
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