Individual
JORGE FABIAN BALDERRAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1410 E JOHN ST, SEATTLE, WA 98112-5218
(206) 323-4935
(206) 323-6029
Mailing address
523 BROADWAY E APT 226, SEATTLE, WA 98102-5373
(915) 920-3982
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60159486
WA
Other
Enumeration date
12/08/2010
Last updated
12/08/2010
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