| NPI | 1174786172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANNE HENRIKSEN Owner 509-943-3030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy Specialty Pharmacy (Licence: WA CF0059189) |
| Additional Taxonomies | 3336C0004X Pharmacy Compounding Pharmacy |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-09 |