Jacob Sullivan, RPH

NPI #1164916656 in Liberty Lake, Washington

Provider Information

NPI Number: 1164916656
Entity Type: Individual
Name: Jacob Sullivan, RPH
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Jun 18, 2018
Last Updated: Jun 18, 2018

Practice Location

Address: 23102 E APPLEWAY AVE
City: Liberty Lake
State: Washington
ZIP Code: 99019-9585
Phone: (509) 928-8738

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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