NPI | 1285822809 |
---|---|
Entity Type | Organization |
Authorized Contact | TERRY L WILSON PA-C Provider/Owner 360-748-9320 |
Organization Subpart ? | No |
Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA PA10000075) |
Enumeration Date | 2007-10-09 |
Last Update Date | 2007-12-20 |