| Doctor Name: | MARTINE DELMULLE |
| NPI Number: | 1013275593 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | |
| License Number: | PH00014555 |
| Business Practice Address: | 4700 Ne 4th St Renton, WA - 980594800 |
| Business Phone Number: | 4257931015 |
| Business Fax Number: | |
| Mailing Address: | 4700 Ne 4th St, RENTON |
| State: | WA |
| Postal Code: | 980594800 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 05/02/2012 |
| NPI Last Update Date: | 05/02/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1835N1003X |
| License Number: | PH00014555 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WA |
| Taxonomy Type: | Pharmacy Service Providers |
| Taxonomy Classification: | Pharmacist |
| Taxonomy Specialization: | Nutrition Support |
| Taxonomy Definition: | A licensed pharmacist who has demonstrated specialized knowledge and skill in maintenance and/or restoration of optimal nutritional status, designing and modifying treatment according to patient needs. |