David Bou
Individual provider Active NPI Pharmacist · Enumclaw, WA
NPI 1922476431 · NPPES record last updated Sep 14, 2015
Key facts
- NPI
- 1922476431
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 60580447 (WA)
- Practice address
- 232 Roosevelt Ave
Enumclaw, WA 98022-8242 - Phone
- (360) 825-2558
- NPI assigned
- Sep 14, 2015
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
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 |
|---|---|---|---|
| 60580447 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 60580447 | WA | Yes |
Addresses
Primary practice location
232 Roosevelt Ave
Enumclaw, WA 98022-8242
Mailing address
232 Roosevelt Ave
Enumclaw, WA 98022-8242
Other providers in Enumclaw, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 14, 2015. 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.