| NPI | 1962532275 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEANNIE BRADLEY President 360-681-6179 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3336S0011X Pharmacy, Specialty Pharmacy (Licence: WA 09730) |
| Enumeration Date | 2007-03-06 |
| Last Update Date | 2012-08-29 |