| NPI | 1720182140 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMMY KVINSLAND Contract Admin 253-858-9941 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy (Licence: WA CF00002146) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy, Compounding Pharmacy | |
| Enumeration Date | 2006-09-08 |
| Last Update Date | 2018-04-12 |