Active NPI
Martin Asobo Kisang
- Pharmacist
- Gig Harbor, WA
National Provider Identifier
1043722432
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60791882
- Practice address
- 4818 Point Fosdick Dr NW
Gig Harbor, WA 98335-1711 - Phone
- (253) 851-3175
- NPI assigned
- Oct 25, 2017
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60791882 | WA | Primary |
Addresses
Primary practice location
4818 Point Fosdick Dr NW
Gig Harbor, WA 98335-1711
Mailing address
102 Summit Ter Apt 14
South Portland, ME 04106-2207
Phone (720) 448-0882
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 |
|---|---|---|---|
| PH60791882 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1508889600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1508889600000",
"number": "1043722432",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "102 SUMMIT TER APT 14",
"city": "SOUTH PORTLAND",
"state": "ME",
"postal_code": "041062207",
"telephone_number": "720-448-0882"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4818 POINT FOSDICK DR NW",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983351711",
"telephone_number": "253-851-3175"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISANG",
"first_name": "MARTIN",
"middle_name": "ASOBO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-10-25",
"last_updated": "2017-10-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60791882",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Gig Harbor, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.