Provider Demographics
NPI:1144922865
Name:SCHROCK, NORMA J
Entity type:Individual
Prefix:MRS
First Name:NORMA
Middle Name:J
Last Name:SCHROCK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:NORMA
Other - Middle Name:J
Other - Last Name:GUSDAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1512 E HAZEL ST
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98274-5156
Mailing Address - Country:US
Mailing Address - Phone:360-223-6801
Mailing Address - Fax:
Practice Address - Street 1:1400 CORNWALL AVE
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4520
Practice Address - Country:US
Practice Address - Phone:360-733-1980
Practice Address - Fax:360-738-4628
Is Sole Proprietor?:No
Enumeration Date:2023-03-17
Last Update Date:2023-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00020569183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician