Active NPI
Myrna Genova
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Everett, WA
National Provider Identifier
1033715875
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PH61081301
- Practice address
- 405 SE Everett Mall Way
Everett, WA 98208-3243 - Phone
- (425) 353-7967
- NPI assigned
- Dec 8, 2020
- 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 |
|---|---|---|---|---|
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PH61081301 | WA | Primary |
Addresses
Primary practice location
405 SE Everett Mall Way
Everett, WA 98208-3243
Mailing address
13416 34TH Ave SE
Mill Creek, WA 98012-4625
Phone (425) 346-7262
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 |
|---|---|---|---|
| PH61081301 | WA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1607385600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1607385600000",
"number": "1033715875",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13416 34TH AVE SE",
"city": "MILL CREEK",
"state": "WA",
"postal_code": "980124625",
"telephone_number": "425-346-7262"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "405 SE EVERETT MALL WAY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982083243",
"telephone_number": "425-353-7967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GENOVA",
"first_name": "MYRNA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-12-08",
"last_updated": "2020-12-08",
"certification_date": "2020-12-08",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0018X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
"state": "WA",
"license": "PH61081301",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.