Individual
MR. JASON KOMODA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
16300 N MARKET PLACE BLVD, NAMPA, ID 83687-7910
(208) 465-6801
(208) 465-6811
Mailing address
16300 N MARKET PLACE BLVD, T-2206, NAMPA, ID 83687-7910
(208) 465-6801
(208) 465-6811
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
P5939
ID
Other
Enumeration date
06/09/2011
Last updated
06/09/2011
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