| NPI | 1942365374 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONALD WAYNE ANDERSON Assistant Secreatry For Enrollment 425-358-9786 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336C0003X Pharmacy Community/Retail Pharmacy (Licence: WA PHAR.CF.60340315) |
| Enumeration Date | 2006-12-26 |
| Last Update Date | 2025-05-06 |