Individual
MISS JILL ANNE FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
1269 MCKINLEY ST, ENUMCLAW, WA 98022-2106
(360) 825-5525
(360) 825-5525
Mailing address
1269 MCKINLEY ST, ENUMCLAW, WA 98022-2106
(360) 825-5525
(360) 825-5525
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13637
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
13637
PHARMACIST LICENSE
WA
Enumeration date
12/27/2006
Last updated
07/08/2007
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