Individual
BRIGHAM R CONSOLIVER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
424 E 2ND ST, PORT ANGELES, WA 98362-3119
(360) 452-4200
(360) 457-6557
Mailing address
123 MARY JO LN, SEQUIM, WA 98382-6973
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PPH00017274
WA
Other
Enumeration date
08/08/2012
Last updated
08/08/2012
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