Provider Demographics
NPI:1679869622
Name:BLEESE, VERLE MILAN (RPH)
Entity Type:Individual
Prefix:MR
First Name:VERLE
Middle Name:MILAN
Last Name:BLEESE
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13201 AURORA AVENUE NORTH
Mailing Address - Street 2:RITE AID
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98133
Mailing Address - Country:US
Mailing Address - Phone:206-364-7676
Mailing Address - Fax:
Practice Address - Street 1:13201 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-7584
Practice Address - Country:US
Practice Address - Phone:206-364-7676
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-28
Last Update Date:2011-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA5044183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist