Provider Demographics
NPI:1548457047
Name:BULL, BARBARA CHRISTINA (LMP)
Entity type:Individual
Prefix:MS
First Name:BARBARA
Middle Name:CHRISTINA
Last Name:BULL
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 101
Mailing Address - Street 2:
Mailing Address - City:MOUNT VERNON
Mailing Address - State:WA
Mailing Address - Zip Code:98273-0101
Mailing Address - Country:US
Mailing Address - Phone:360-420-6639
Mailing Address - Fax:
Practice Address - Street 1:321 W WASHINGTON ST
Practice Address - Street 2:SUITE 312
Practice Address - City:MOUNT VERNON
Practice Address - State:WA
Practice Address - Zip Code:98273-5920
Practice Address - Country:US
Practice Address - Phone:360-420-6639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-27
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00019701225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist