Active NPI
Jason Shimata, PHARMD
- Pharmacist
- Camas, WA
National Provider Identifier
1003102765
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH 00061759
- Practice address
- 19610 SE 1St St
Camas, WA 98607-7472 - Phone
- (360) 258-6230
- Fax
- (360) 258-6227
- NPI assigned
- Jun 21, 2011
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH 00061759 | WA | Primary |
| Pharmacist | 183500000X | RPH-0010531 | OR |
Addresses
Primary practice location
19610 SE 1St St
Camas, WA 98607-7472
Mailing address
19610 SE 1St St
Camas, WA 98607-7472
Phone (360) 258-6230
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RPH-0010531 | OR | MD | Pharmacist |
| PH 00061759 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1308614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1308614400000",
"number": "1003102765",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "19610 SE 1ST ST",
"city": "CAMAS",
"state": "WA",
"postal_code": "986077472",
"telephone_number": "360-258-6230",
"fax_number": "360-258-6227"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "19610 SE 1ST ST",
"city": "CAMAS",
"state": "WA",
"postal_code": "986077472",
"telephone_number": "360-258-6230",
"fax_number": "360-258-6227"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIMATA",
"first_name": "JASON",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2011-06-21",
"last_updated": "2011-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH 00061759",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "OR",
"license": "RPH-0010531",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Camas, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.