CLETUS LESIA GANA FOMBAN

TUMWATER, WA
NPI1265941256
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy183500000X Pharmacist
(Licence: WA  ph60759925)
Enumeration Date2017-09-22
Last Update Date2022-07-21
Business Address
CLETUS LESIA GANA FOMBAN ph 60759925
702 TROSPER RD SW
TUMWATER, WA 98512
Phone number: 360-943-5178
Mailing Address
CLETUS LESIA GANA FOMBAN ph 60759925
702 TROSPER RD SW
TUMWATER, WA 98512-6934
Phone number: 360-943-5178