| NPI | 1851101703 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER LYNN KREIDLER-MOSS CEO 360-377-3776 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy |
| Additional Taxonomies | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| 333600000X Pharmacy | |
| Enumeration Date | 2025-01-13 |
| Last Update Date | 2025-01-13 |