| NPI | 1912073388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN ARDELL MOE Practice Management Administrator 206-263-8807 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 3336C0002X Pharmacy, Clinic Pharmacy (Licence: WA FO00055849) |
| Enumeration Date | 2006-11-28 |
| Last Update Date | 2022-10-13 |