Registry details
Type
Individual
Primary specialty
Pharmacist
Enumerated
Mar 10, 2021
License(s)
61756 (TX), PH61156144 (WA)
Addresses on file
| Purpose | Address | City/State | Phone |
|---|---|---|---|
| LOCATION | 16824 HIGHWAY 99 | Lynnwood, WA 98037-3167 | 585-201-1534 |
| MAILING | 3200 S INTERSTATE 35 E APT 3301 | Denton, TX 76210-6919 | 585-201-1534 |
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