Provider Demographics
NPI:1881862860
Name:BULLEN, KARLA (LMP)
Entity Type:Individual
Prefix:MS
First Name:KARLA
Middle Name:
Last Name:BULLEN
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14301 25TH AVENUE CT E
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98445-4923
Mailing Address - Country:US
Mailing Address - Phone:253-230-9845
Mailing Address - Fax:253-537-8504
Practice Address - Street 1:9508 CANYON RD E
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98371-6302
Practice Address - Country:US
Practice Address - Phone:253-230-9845
Practice Address - Fax:253-537-8504
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-13
Last Update Date:2008-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00017611175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath