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Individual

CELITA LOUISE SUMMERRISE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
27520 COVINGTON WAY SE, COVINGTON, WA 98042
(253) 796-1011
Mailing address
4045 S 212TH CT, UNIT C, SEATAC, WA 98198
(206) 683-4765

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60240463
WA

Other

Enumeration date
11/14/2011
Last updated
11/14/2011
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