Provider Demographics
NPI:1376850297
Name:GULLEY, KAYLA JANE (PHARMD)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:JANE
Last Name:GULLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:JANE
Other - Last Name:KENT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:747 BROADWAY
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-4307
Mailing Address - Country:US
Mailing Address - Phone:206-386-3047
Mailing Address - Fax:
Practice Address - Street 1:747 BROADWAY
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122
Practice Address - Country:US
Practice Address - Phone:206-386-3047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-09-13
Last Update Date:2018-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60175661183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist