| NPI | 1861423717 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES HENRIKSEN Owner 509-943-9173 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WA PHAR.CF.60176819) |
| Additional Taxonomies | 333600000X Pharmacy |
| 3336C0004X Pharmacy Compounding Pharmacy | |
| Enumeration Date | 2006-07-06 |
| Last Update Date | 2016-01-15 |