Candice Fuller, PHARM.D, BCCP

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60324172 Issued in WA

Practice address

62 W 7TH Ave
Spokane, WA 99204-2321

Phone

(509) 474-2041

Fax

(509) 474-4906

NPI assigned

Oct 16, 2006

Last updated

Dec 14, 2020By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Doctor of Pharmacy

State licenses

Practice roles

Locations

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.

• Providence Health & Services Washington

  dba Providence Spokane Heart Institute

  • Cardiovascular Disease Physician
  • Spokane, WA
  • NPI 1881907715
  NPD
• Providence Health & Services-Wa

  dba NW Heart & Lung Surgical Assoc

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Spokane, WA
  • NPI 1538311287
  NPD

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

{
    "created_epoch": "1160956800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1607904000000",
    "number": "1639269806",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5TH AVE & ROOSEVELT",
            "address_2": "PHARMACY SERVICE (119)",
            "city": "HINES",
            "state": "IL",
            "postal_code": "60141",
            "telephone_number": "708-202-8387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "62 W 7TH AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992042321",
            "telephone_number": "509-474-2041",
            "fax_number": "509-474-4906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FULLER",
        "first_name": "CANDICE",
        "credential": "PHARM.D, BCCP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-10-16",
        "last_updated": "2020-12-14",
        "certification_date": "2020-12-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60324172",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brent Fukushima, SRNA
• Constance S Fulk, L.M.P.
• Full Circle Therapy PLLC (Full Circle Therapy)
• Aayiana Fuller
• Bailey Rae Fuller
• Carson Fuller, MD
• Cindi L Fuller, MSW
• Dana R Fuller, MA, LMFTA
• Debra Johnson Fuller, ARNP
• Donald R Fuller, CCC-SLP

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2020; 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.