Provider Demographics
NPI:1205121563
Name:GREKUL, JAMES MICHAEL (JAMES GREKUL)
Entity type:Individual
Prefix:MR
First Name:JAMES
Middle Name:MICHAEL
Last Name:GREKUL
Suffix:
Gender:M
Credentials:JAMES GREKUL
Other - Prefix:MR
Other - First Name:JAMES
Other - Middle Name:
Other - Last Name:GREKUL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RPH
Mailing Address - Street 1:8 GRAND VIEW LN
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-2743
Mailing Address - Country:US
Mailing Address - Phone:369-510-6947
Mailing Address - Fax:
Practice Address - Street 1:3227 NORTHWEST AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-1317
Practice Address - Country:US
Practice Address - Phone:360-647-2175
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-15
Last Update Date:2011-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00017337183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist