| NPI | 1760148027 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA BLAND Pm 360-616-3145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy, Community/Retail Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2022-06-07 |