Individual
MARIA WAMANSJAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMACIST
Contact information
Practice address
3716 S 144TH ST, TUKWILA, WA 98168-4045
(206) 204-1284
Mailing address
3716 S 144TH ST, TUKWILA, WA 98168-4045
(206) 204-1284
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PS00021696
WA
Other
Enumeration date
12/22/2009
Last updated
12/22/2009
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