Gloria D Bullo
Individual provider Active NPI Pharmacist · Sumner, WA
NPI 1851658017 · NPPES record last updated Apr 12, 2012
Key facts
- NPI
- 1851658017
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 9869 (WA)
- Practice address
- 1201 Valley Ave E
Sumner, WA 98390-3225 - Phone
- (253) 826-8433
- Fax
- (253) 826-8427
- NPI assigned
- Apr 12, 2012
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 9869 | WA | MD | Pharmacist |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 9869 | WA | Yes |
Addresses
Primary practice location
1201 Valley Ave E
Sumner, WA 98390-3225
Mailing address
1201 Valley Ave E
Sumner, WA 98390-3225
Phone (253) 826-8433
Other providers in Sumner, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 12, 2012. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.