Active NPI
Stacy Lynn Graham, CPHT
- Pharmacy Technician
- Kennewick, WA
National Provider Identifier
1003490459
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- VA60316223
- Practice address
- 1901 N Steptoe St
Kennewick, WA 99336-7120 - Phone
- (509) 783-3413
- Fax
- (509) 735-2802
- NPI assigned
- May 11, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | VA60316223 | WA | Primary |
Addresses
Primary practice location
1901 N Steptoe St
Kennewick, WA 99336-7120
Mailing address
1901 N Steptoe St
Kennewick, WA 99336-7120
Phone (509) 987-4890
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VA60316223 | WA | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thrifty Payless Inc | Past | Accepting new patients | |
| Thrifty Payless Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Kennewick, WA
- NPI 1801905112
-
- Community/Retail Pharmacy
- Winchester, CA
- NPI 1437874062
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620691200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1624233600000",
"number": "1003490459",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1901 N STEPTOE ST",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993367120",
"telephone_number": "509-987-4890"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 N STEPTOE ST",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993367120",
"telephone_number": "509-783-3413",
"fax_number": "509-735-2802"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GRAHAM",
"first_name": "STACY",
"middle_name": "LYNN",
"credential": "CPHT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-11",
"last_updated": "2021-06-21",
"certification_date": "2021-06-21",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "WA",
"license": "VA60316223",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.