Provider Demographics
NPI:1457600108
Name:BURRESS, ASHLEY MONIQUE (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:ASHLEY
Middle Name:MONIQUE
Last Name:BURRESS
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8825 34TH AVE NE
Mailing Address - Street 2:A
Mailing Address - City:TULALIP
Mailing Address - State:WA
Mailing Address - Zip Code:98271-8085
Mailing Address - Country:US
Mailing Address - Phone:360-716-2660
Mailing Address - Fax:
Practice Address - Street 1:8825 34TH AVE NE
Practice Address - Street 2:A
Practice Address - City:TULALIP
Practice Address - State:WA
Practice Address - Zip Code:98271-8085
Practice Address - Country:US
Practice Address - Phone:360-716-2660
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-09-07
Last Update Date:2012-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60295197183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist