Individual
DESARONE CHANTHAVONG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
11696 NE 76TH ST, VANCOUVER, WA 98662-3941
(360) 944-2665
(360) 944-2669
Mailing address
11696 NE 76TH ST, VANCOUVER, WA 98662-3941
(360) 944-2665
(360) 944-2669
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00017390
WA
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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