Individual provider Active NPI

Tibursious Ssendawula

  • Pharmacist
  • Bellingham, WA
National Provider Identifier
1043680812
Registry record updated Oct 5, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60574888 Issued in WA
Practice address
220 36TH St
Bellingham, WA 98225-6540
Phone
(360) 734-8254
NPI assigned
Oct 5, 2015
Last updated
Oct 5, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 5, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60574888 WA Primary

Addresses

Primary practice location

220 36TH St
Bellingham, WA 98225-6540

Mailing address

220 36TH St
Bellingham, WA 98225-6540

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

LicenseStateTypeSpecialty
PH60574888WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444003200000",
    "number": "1043680812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 36TH ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982256540"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 36TH ST",
            "city": "BELLINGHAM",
            "state": "WA",
            "postal_code": "982256540",
            "telephone_number": "360-734-8254"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SSENDAWULA",
        "first_name": "TIBURSIOUS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-10-05",
        "last_updated": "2015-10-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60574888",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bellingham, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 5, 2015; 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.