Active NPI
Virginia Mason Medical Center
- Pharmacy
- Issaquah, WA
National Provider Identifier
1043214596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- 262010304679
- Legal business name
- VIRGINIA MASON MEDICAL CENTER
- Practice address
- 100 NE Gilman Blvd
Issaquah, WA 98027-2925 - Phone
- (425) 557-8003
- Fax
- (425) 557-8021
- NPI assigned
- Jun 10, 2005
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Ms. Rose Wong, RPH. PHARM D
- Title
- Lead Pharmacist
- Phone
- (425) 557-8003
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | 262010304679 | WA | Primary |
Addresses
Primary practice location
100 NE Gilman Blvd
Issaquah, WA 98027-2925
Mailing address
100 NE Gilman Blvd
Issaquah, WA 98027-2925
Phone (425) 557-8003
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 4922806 | Other | WA | NCPDP |
| 6012926 | Medicaid | WA |
Other names 1
- Issaquah Pharmacy
National Provider Directory
National Provider Directory- Tax ID family
- Virginia Mason Occup Me
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NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1118361600000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1598054400000",
"number": "1043214596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "100 NE GILMAN BLVD",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980272925",
"telephone_number": "425-557-8003",
"fax_number": "425-557-8021"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 NE GILMAN BLVD",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980272925",
"telephone_number": "425-557-8003",
"fax_number": "425-557-8021"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "VIRGINIA MASON MEDICAL CENTER",
"organizational_subpart": "NO",
"enumeration_date": "2005-06-10",
"last_updated": "2020-08-22",
"status": "A",
"authorized_official_last_name": "WONG",
"authorized_official_first_name": "ROSE",
"authorized_official_title_or_position": "LEAD PHARMACIST",
"authorized_official_telephone_number": "425-557-8003",
"authorized_official_name_prefix": "Ms.",
"authorized_official_credential": "RPH. PHARM D"
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "WA",
"license": "262010304679",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "NCPDP",
"identifier": "4922806",
"state": "WA"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6012926",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Issaquah Pharmacy",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Issaquah, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 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.