Mariam Boulos, PH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60402489 Issued in WA

Practice address

3905 Factoria Mall SE
Bellevue, WA 98006

Phone

(425) 644-2925

NPI assigned

Mar 20, 2015

Last updated

Mar 20, 2015By 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

State licenses

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

{
    "created_epoch": "1426809600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426809600000",
    "number": "1992199640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "850A NE 123RD ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981254830"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3905 FACTORIA MALL SE",
            "city": "BELLEVUE",
            "state": "WA",
            "postal_code": "98006",
            "telephone_number": "425-644-2925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOULOS",
        "first_name": "MARIAM",
        "credential": "PH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-03-20",
        "last_updated": "2015-03-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60402489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Carola E Bosenberg, MD
• Jara B Bosmans
• Boston Medical Group- Washington, P.C.
• James E Boswell, M.D.
• Michael Vasile Bota, M.D.
• Mixayphone Bounvilay, RN
• Kerry Elizabeth Bowen, PA
• Brooke Katherine Bower, MT-BC
• Laurie Cameron Bowers, M.A., LMFT
• Robert Francis Bowers III, MD

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2015; 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.