=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598889180
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | SUSAN ELIZABETH BIELINSKI R.PH.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/19/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 4508 AUBURN WAY N SUITE A-104
-----------------------------------------------------
City | AUBURN
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98002-1381
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-373-9944
-----------------------------------------------------
Fax | 253-373-9946
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 13835 SE 260TH ST
-----------------------------------------------------
City | KENT
-----------------------------------------------------
State | WA
-----------------------------------------------------
Zip | 98042-3532
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 253-631-5302
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 183500000X
-----------------------------------------------------
Taxonomy Name | Pharmacist
-----------------------------------------------------
License Number | PH00010626
-----------------------------------------------------
License Number State | WA
-----------------------------------------------------