Provider Demographics
NPI:1154535664
Name:NULPH, CAMILLE MARIE (PHARM D)
Entity type:Individual
Prefix:MRS
First Name:CAMILLE
Middle Name:MARIE
Last Name:NULPH
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 COYOTE RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-8731
Mailing Address - Country:US
Mailing Address - Phone:208-589-9155
Mailing Address - Fax:
Practice Address - Street 1:1700 SE MEADOWBROOK BLVD
Practice Address - Street 2:WALMART PHARMACY
Practice Address - City:COLLEGE PLACE
Practice Address - State:WA
Practice Address - Zip Code:99324
Practice Address - Country:US
Practice Address - Phone:509-525-3626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-10
Last Update Date:2023-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP60321835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy