Provider Demographics
NPI:1861757700
Name:HURUBEANU, NICOLETA RALUCA
Entity type:Individual
Prefix:MISS
First Name:NICOLETA
Middle Name:RALUCA
Last Name:HURUBEANU
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11117 NE 109TH LN APT N203
Mailing Address - Street 2:
Mailing Address - City:KIRKLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98033-5093
Mailing Address - Country:US
Mailing Address - Phone:603-667-6583
Mailing Address - Fax:425-487-2004
Practice Address - Street 1:11117 NE 109TH LN APT N203
Practice Address - Street 2:
Practice Address - City:KIRKLAND
Practice Address - State:WA
Practice Address - Zip Code:98033-5093
Practice Address - Country:US
Practice Address - Phone:603-667-6583
Practice Address - Fax:425-487-2004
Is Sole Proprietor?:Yes
Enumeration Date:2012-07-06
Last Update Date:2012-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60192689183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist