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Individual

SHEENA PRUETT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CPHT

Contact information

Practice address
22201 MERIDIAN E, GRAHAM, WA 98338-8987
(253) 846-9455
(253) 846-9462
Mailing address
22907 46TH AVE E, SPANAWAY, WA 98387-6106
(253) 286-9169

Taxonomy

Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA00066206
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
NONE
NONE
WA
01
NONE
NONE
Enumeration date
07/30/2021
Last updated
07/30/2021
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