Ibtissam N Boulos, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH00011157 Issued in WA

Practice address

1225 W Bakerview Rd
Bellingham, WA 98226-9691

Phone

(360) 788-2933

NPI assigned

Feb 24, 2012

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fred Meyer Stores Inc

  • Community/Retail Pharmacy
  • Bellingham, WA
  • NPI 1760427108
  NPD (past)
• Fred Meyer Stores Inc.

  • Community/Retail Pharmacy
  • Lynnwood, WA
  • NPI 1558235762
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1003180845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1225 W BAKERVIEW RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269691",
            "telephone_number": "360-788-2933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1225 W BAKERVIEW RD",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982269691",
            "telephone_number": "360-788-2933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "IBTISSAM",
        "middle_name": "N",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00011157",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jolene Bosworth
• Katharine Margaret Botelle Wolhart, MSW, LICSW
• Kylee Christina Bott
• Jonathan M Boudin, M.ED., LMHCA
• Jennifer Marie Boudreau, LMP, AS
• Shannon Adam Boustead, M.D.
• Bruce A. Bowden, MD
• Kay Ann Bowers, BA
• Jaclyn Joann Adams Bowker, MD
• Julie Anne Bowman, LMT

• Pharmacist in Bellingham, WA
• Providers in Bellingham, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.