Individual
J LOUISE ULLOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
602 E NOB HILL BLVD, YAKIMA, WA 98901-3534
(509) 248-3334
(509) 453-6144
Mailing address
PO BOX 190, TOPPENISH, WA 98948-0190
(509) 865-6175
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD00033670
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
911019392
COMMERCIAL
—
Enumeration date
10/03/2006
Last updated
04/12/2018
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