Provider Demographics
NPI:1003286048
Name:GULELAT, HIRUT
Entity Type:Individual
Prefix:
First Name:HIRUT
Middle Name:
Last Name:GULELAT
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5832 NE 75TH ST # 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-8110
Mailing Address - Country:US
Mailing Address - Phone:206-310-4101
Mailing Address - Fax:
Practice Address - Street 1:1225 W BAKERVIEW RD
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-9691
Practice Address - Country:US
Practice Address - Phone:360-788-2933
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-02
Last Update Date:2015-10-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00019843183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist