Provider Demographics
NPI:1588764393
Name:BONDURANT, HOLLYE CRUTCHER (PHARMD)
Entity type:Individual
Prefix:MS
First Name:HOLLYE
Middle Name:CRUTCHER
Last Name:BONDURANT
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2118 46TH AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98116-2106
Mailing Address - Country:US
Mailing Address - Phone:206-437-1424
Mailing Address - Fax:
Practice Address - Street 1:1660 S COLUMBIAN WAY
Practice Address - Street 2:S-119-PHAR
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98108-1532
Practice Address - Country:US
Practice Address - Phone:206-764-2143
Practice Address - Fax:206-764-2380
Is Sole Proprietor?:No
Enumeration Date:2006-09-22
Last Update Date:2015-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00060091183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist