Individual
ISA LIM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2707 RAINIER AVE S, SEATTLE, WA 98144-5332
(206) 721-5018
Mailing address
2707 RAINIER AVE S, SEATTLE, WA 98144-5332
(206) 721-5018
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH 60477703
WA
Other
Enumeration date
10/02/2014
Last updated
10/02/2014
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