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General NPI Number Information
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NPI Number | 1881408482
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Entity Type | Individual
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Provider Name | BAO GIA BUI PHARMD
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Gender | Male
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Dates
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Enumeration Date | 02/04/2025
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Last Update Date | 02/04/2025
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Provider Practice Location Address
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Address Line | 364 TRIANGLE SHOPPING CTR
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City | LONGVIEW
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State | WA
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Zip | 98632-4651
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Country | US
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Telephone | 360-423-4833
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Fax | 360-636-0901
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Provider Business Mailing Address
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Address Line | 4620 NE 105TH AVE
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City | PORTLAND
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State | OR
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Zip | 97220-3352
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Country | US
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Telephone | 971-276-4997
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH61577349
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License Number State | WA
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