MR. Kenneth R Petersen, RPH

NPI #1972879401 in Lacey, Washington

Provider Information

NPI Number: 1972879401
Entity Type: Individual
Name: MR. Kenneth R Petersen, RPH
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Pharmacist
Credential: RPH
Enumeration Date: Mar 29, 2012
Last Updated: Mar 29, 2012

Practice Location

Address: 5500 MARTIN WAY E
City: Lacey
State: Washington
ZIP Code: 98516-6326
Phone: (360) 456-4057

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Pharmacist	183500000X	Primary

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