Individual
CULLEN PENNER-RAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1121 124TH AVE NE, BELLEVUE, WA 98005-2101
(406) 422-3379
Mailing address
2162 NE HOSTMARK ST APT 37, POULSBO, WA 98370-7339
(406) 422-3379
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
607774097
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60774097
PHARMACIST LICENSE
WA
Enumeration date
09/25/2017
Last updated
09/25/2017
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