| NPI | 1467842161 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHIA M. KELLER Owner 425-898-4732 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 332900000X Non-Pharmacy Dispensing Site (Licence: WA MD00040426) |
| Enumeration Date | 2015-02-02 |
| Last Update Date | 2015-10-05 |