Individual
JORDAN DIECKMANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
16605 6TH AVE W, APT M308, LYNNWOOD, WA 98037-9372
(509) 531-9940
Mailing address
16605 6TH AVE W, APT M308, LYNNWOOD, WA 98037-9372
(509) 531-9940
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60632450
WA
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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