Provider Demographics
NPI:1720707177
Name:BHALERAO, MRUNAL SANJEEV (PHARMD)
Entity Type:Individual
Prefix:
First Name:MRUNAL
Middle Name:SANJEEV
Last Name:BHALERAO
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 1:1601 NE KATSURA ST UNIT 803
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-7694
Mailing Address - Country:US
Mailing Address - Phone:425-274-6188
Mailing Address - Fax:
Practice Address - Street 1:107 BELLEVUE WAY SE
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98004-6229
Practice Address - Country:US
Practice Address - Phone:425-454-1818
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-26
Last Update Date:2022-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61325949183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist