Provider Demographics
NPI:1649305384
Name:MARSHLAIN, E. BRUCE (RPH)
Entity type:Individual
Prefix:MR
First Name:E.
Middle Name:BRUCE
Last Name:MARSHLAIN
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 1:2702 143RD PL SE
Mailing Address - Street 2:
Mailing Address - City:MILL CREEK
Mailing Address - State:WA
Mailing Address - Zip Code:98012-5798
Mailing Address - Country:US
Mailing Address - Phone:425-481-1329
Mailing Address - Fax:
Practice Address - Street 1:1120 HARVARD AVE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98122-4206
Practice Address - Country:US
Practice Address - Phone:206-324-6990
Practice Address - Fax:206-329-1849
Is Sole Proprietor?:No
Enumeration Date:2007-02-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00009180183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist