| NPI | 1053489062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA DERRY Administrator 253-428-8700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: WA PF00056036) |
| Enumeration Date | 2006-11-30 |
| Last Update Date | 2020-08-22 |