Individual
JORDAN LEE ERICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARMACIST
Contact information
Practice address
2109 E BROADWAY, MOUNT VERNON, WA 98274-4628
(360) 395-8682
Mailing address
2109 E BROADWAY, MOUNT VERNON, WA 98274-4628
(360) 395-8682
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH61066697
WA
Other
Enumeration date
08/21/2020
Last updated
08/21/2020
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