NPIMap

Individual provider Active NPI

Emily I Bulley, MD

  • Internal Medicine Physician
  • Olympia, WA
National Provider Identifier
1356875421
Registry record updated Nov 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
MD60983549 Issued in WA
Practice address
1620 Cooper Point Rd SW
Olympia, WA 98502-5736
Phone
(604) 866-7103
Fax
(360) 705-0269
NPI assigned
Apr 16, 2017
Last updated
Nov 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 3, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X MD60983549 WA Primary

Addresses

Primary practice location

1620 Cooper Point Rd SW
Olympia, WA 98502-5736

Mailing address

1620 Cooper Point Rd SW
Olympia, WA 98502-5736
Phone (604) 866-7103

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200501000152 WA Practitioner - Internal Medicine 4587932660 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Washington School of Medicine, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

1620 Cooper Point Rd SW
Olympia, WA 98502-5736
Phone (306) 486-6710

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD60983549WAMDInternal Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Providence Health & Services Washington CurrentSince Oct 10, 2022 Accepting new patients
Providence Health & Services - Washington Past Accepting new patients
Association of University Physicians Internal Medicine PastSince May 1, 2020 Accepting new patients

Locations

1620 Cooper Point Rd SW
Olympia, WA 98502
Phone (360) 486-6710

525 Lilly Rd NE
Olympia, WA 98506
Phone (360) 413-8550

Interoperability endpoints

  • Direct secure messaging: ebulley533825@wm.providencedirect.org

Organizations & group practices 3

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

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1492300800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667433600000",
    "number": "1356875421",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1620 COOPER POINT RD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025736",
            "telephone_number": "604-866-7103",
            "fax_number": "360-705-0269"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1620 COOPER POINT RD SW",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985025736",
            "telephone_number": "604-866-7103",
            "fax_number": "360-705-0269"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLEY",
        "first_name": "EMILY",
        "middle_name": "I",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-04-16",
        "last_updated": "2022-11-03",
        "certification_date": "2022-11-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WA",
            "license": "MD60983549",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Olympia, WA

Sources for this page

Verify at the official NPI Registry.