Active NPI
Spartak Alexander Mednikov, PHARMD
- Critical Care Pharmacist
- Tacoma, WA
National Provider Identifier
1013892868
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Critical Care Pharmacist
- License
- PH60234855
- 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
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 |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PH60234855 | WA | MD | Critical 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.