W Dale Gross

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHARCF00000329 Issued in WA

Legal business name

W DALE GROSS

Practice address

2520 Foster Ave
Bridgeport, WA 98813-1029

Phone

(509) 686-5191

Fax

(509) 686-2807

NPI assigned

Jan 30, 2007

Organization subpart

No

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

Authorized official

Name

Walter Gross

Title

Owner and Phcist

Phone

(509) 686-5191

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• GROSS DRUGS Doing business as

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

{
    "created_epoch": "1170115200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392854400000",
    "number": "1164568721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1029",
            "city": "BRIDGEPORT",
            "state": "WA",
            "postal_code": "988131029",
            "telephone_number": "509-686-5191",
            "fax_number": "509-686-5191"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 FOSTER AVE",
            "city": "BRIDGEPORT",
            "state": "WA",
            "postal_code": "988131029",
            "telephone_number": "509-686-5191",
            "fax_number": "509-686-2807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "W DALE GROSS",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-30",
        "last_updated": "2014-02-20",
        "status": "A",
        "authorized_official_last_name": "GROSS",
        "authorized_official_first_name": "WALTER",
        "authorized_official_title_or_position": "OWNER AND PHCIST",
        "authorized_official_telephone_number": "509-686-5191"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHARCF00000329",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6145700",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106566",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GROSS DRUGS",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Joshua Monson, MD
• Catherine Lynn Mullin, SLPA
• Daisy Sajuan, NP-C
• Viridiana Sanchez Mejia
• Susan Renee Sloan, RN BSN
• Tony Ye Yan, DDS

• Community/Retail Pharmacy in Bridgeport, WA
• Providers in Bridgeport, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; 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.