Individual
TARA ANNE JERMASEK
Active
Sole proprietor
Provider details
NPI number
Gender
F
Contact information
Practice address
6602 64TH ST NE, MARYSVILLE, WA 98270-4834
(360) 658-5218
(360) 658-5549
Mailing address
27131 102ND AVE NW, STANWOOD, WA 98292-8009
(360) 658-5218
(360) 658-5549
Taxonomy
Speciality
Code
Description
License number
State
183700000X
Pharmacy Technician
Primary
VA00044253
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
VA00044253
LICENSE NUMBER
WA
Enumeration date
11/25/2005
Last updated
07/08/2007
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