Provider Demographics
NPI:1487713301
Name:BOSCH, GAIL (RPH, CGP)
Entity type:Individual
Prefix:
First Name:GAIL
Middle Name:
Last Name:BOSCH
Suffix:
Gender:F
Credentials:RPH, CGP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:177 NW CARTER FARMS CT
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-2090
Mailing Address - Country:US
Mailing Address - Phone:360-792-9363
Mailing Address - Fax:360-792-9325
Practice Address - Street 1:177 NW CARTER FARMS CT
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2090
Practice Address - Country:US
Practice Address - Phone:360-792-9363
Practice Address - Fax:360-792-9325
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH000617561835G0303X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835G0303XPharmacy Service ProvidersPharmacistGeriatric