Cletus Lesia Gana Fomban, PH 60759925
NPI #1265941256 in Tumwater, Washington
Provider Information
- NPI Number
- 1265941256
- Entity Type
- Individual
- Name
- Cletus Lesia Gana Fomban, PH 60759925
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Pharmacist
- Credential
- PH 60759925
- Enumeration Date
- Sep 22, 2017
- Last Updated
- Jul 21, 2022
Practice Location
- Address
- 702 TROSPER RD SW
- City
- Tumwater
- State
- Washington
- ZIP Code
- 98512
- Phone
- (360) 943-5178
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pharmacist |
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