Individual
MARIAM BOULOS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PH
Contact information
Practice address
3905 FACTORIA MALL SE, BELLEVUE, WA 98006
(425) 644-2925
Mailing address
850A NE 123RD ST, SEATTLE, WA 98125-4830
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH60402489
WA
Other
Enumeration date
03/20/2015
Last updated
03/20/2015
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