| NPI | 1588939284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTE LEVAQUE Rph/Member 360-419-0928 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0004X Pharmacy Compounding Pharmacy (Licence: WA PHAR.CF.60274451) |
| Enumeration Date | 2012-03-13 |
| Last Update Date | 2012-03-13 |