| NPI | 1235509126 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALICIA GONZALEZ Owner 425-689-7007 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: WA NT00001131) |
| Enumeration Date | 2015-10-05 |
| Last Update Date | 2015-10-05 |