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Individual

HOA LE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055
(360) 449-1600
Mailing address
12607 SE MILL PLAIN BLVD, VANCOUVER, WA 98684-6055

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0016368
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
PH-60781638
WA
390200000X
Student in an Organized Health Care Education/Training Program
PI-0011730
OR

Other

Enumeration date
06/27/2017
Last updated
02/28/2024
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