Individual provider Active NPI

Spartak Alexander Mednikov, PHARMD

  • Critical Care Pharmacist
  • Tacoma, WA
National Provider Identifier
1013892868
Registry record updated Aug 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Care PharmacistTaxonomy code 1835C0205X
License
PH60234855 Issued in WA
Practice address
315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone
(253) 403-3755
NPI assigned
Aug 11, 2025
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 11, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Care Pharmacist 1835C0205X PH60234855 WA Primary

Addresses

Primary practice location

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234

Mailing address

6420 86TH Ave W
University Place, WA 98467-4055
Phone (206) 816-5954

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

LicenseStateTypeSpecialty
PH60234855WAMDCritical Care Pharmacist

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1754870400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1754870400000",
    "number": "1013892868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6420 86TH AVE W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984674055",
            "telephone_number": "206-816-5954"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-403-3755"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEDNIKOV",
        "first_name": "SPARTAK",
        "middle_name": "ALEXANDER",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2025-08-11",
        "last_updated": "2025-08-11",
        "certification_date": "2025-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835C0205X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Critical Care",
            "state": "WA",
            "license": "PH60234855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.