Individual
DR. FORTUNATE MWANAKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
310 31ST AVE SE, PUYALLUP, WA 98374-1232
(253) 770-9889
Mailing address
310 31ST AVE SE, PUYALLUP, WA 98374-1232
(253) 770-9889
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
6093
ND
183500000X
Pharmacist
Primary
PH60985395
WA
Other
Enumeration date
11/20/2018
Last updated
03/06/2023
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