Individual
MIMOSA HANSCHE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4700 NE 4TH ST, RENTON, WA 98059-4800
(425) 793-1015
Mailing address
4700 NE 4TH ST, RENTON, WA 98059-4800
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA60140560
WA
Other
Enumeration date
07/18/2012
Last updated
07/18/2012
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