| NPI | 1326598640 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN IPSEN Owner 425-881-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: WA PHAR.CF.6069307) |
| Additional Taxonomies | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Enumeration Date | 2016-10-11 |
| Last Update Date | 2017-02-16 |