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Individual

MR. JOHN TYLER BAKEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
12 N 9TH AVE, YAKIMA, WA 98902-3065
(509) 966-4865
(509) 452-0342
Mailing address
12 N 9TH AVE, YAKIMA, WA 98902-3065
(509) 966-4865
(509) 452-0342

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH 9879
WA

Other

Enumeration date
04/18/2011
Last updated
04/18/2011
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