| NPI | 1508907130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARK CLARK Owner 425-881-0222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy, Compounding Pharmacy (Licence: WA CF00002400) |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2020-08-22 |