Mia Rose Wurtz

Primary specialty

PharmacistTaxonomy code 183500000X

License

IR60413879 Issued in WA

Practice address

111 S 44TH St
Bellingham, WA 98229-2865

Phone

(253) 241-6805

NPI assigned

Jun 14, 2016

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

Other names 1

• Mia Rose Dydek Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1465862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1465862400000",
    "number": "1881044550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 S 44TH ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982292865",
            "telephone_number": "253-241-6805"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 S 44TH ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982292865",
            "telephone_number": "253-241-6805"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WURTZ",
        "first_name": "MIA",
        "middle_name": "ROSE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-14",
        "last_updated": "2016-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "IR60413879",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MIA",
            "last_name": "DYDEK",
            "middle_name": "ROSE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Nicole Wright
• Sara Anne Wright, CERTIFIED DOULA
• Theodore Charles Wright, M.D.
• Chao-Ying Wu, MD
• Deborah Wu, OD
• Chaia Wylder, AAC
• Douglas Wynne, MD
• Emily Y Wynne
• Ryan William Wynne, D.D.S., MSD
• Thomas Frank Wynne, CDP

• 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 Jun 14, 2016; 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.