Individual
BASAVARAJU BORRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
955 POWELL AVE SW, RENTON, WA 98057-2908
(425) 277-1311
Mailing address
955 POWELL AVE SW, RENTON, WA 98057-2908
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00019930
WA
Other
Enumeration date
09/03/2014
Last updated
09/03/2014
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