Individual provider Active NPI

Vittoria Wen, PHARMD

  • Pharmacist
  • Lakewood, WA
National Provider Identifier
1043868011
Registry record updated Sep 3, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60875945 Issued in WA
Practice address
9400 Gravelly Lake Dr SW
Lakewood, WA 98499-1512
Phone
(816) 830-3104
NPI assigned
Sep 3, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 3, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60875945 WA Primary

Addresses

Primary practice location

9400 Gravelly Lake Dr SW
Lakewood, WA 98499-1512

Mailing address

4918 51St Avenue CT W
University Place, WA 98467-4828
Phone (816) 830-3104

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

LicenseStateTypeSpecialty
PH60875945WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Washington CVS Pharmacy LLC PastSince Sep 8, 2019 Accepting new patients
Washington CVS Pharmacy LLC PastSince Sep 8, 2019 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1567468800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567468800000",
    "number": "1043868011",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4918 51ST AVENUE CT W",
            "city": "UNIVERSITY PLACE",
            "state": "WA",
            "postal_code": "984674828",
            "telephone_number": "816-830-3104"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9400 GRAVELLY LAKE DR SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984991512",
            "telephone_number": "816-830-3104"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEN",
        "first_name": "VITTORIA",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-03",
        "last_updated": "2019-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60875945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2019; 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.