Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 175L00000X | Homeopath | MA00017611 | WA |
NPI | 1881862860 |
---|---|
Provider Name | Ms. Karla Bullen |
First Address | Tacoma, WA 98445-4923 |
Second Address | Puyallup, WA 98371-6302 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 13/02/2008 |
Last Update Date | 13/02/2008 |