Individual provider Active NPI

Jyotsna Ravishankar, RPH

  • Pharmacist
  • Issaquah, WA
National Provider Identifier
1053640045
Registry record updated Dec 22, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00065073 Issued in WA
Practice address
6300 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-8935
Phone
(425) 369-0265
NPI assigned
Dec 22, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 22, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00065073 WA Primary

Addresses

Primary practice location

6300 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-8935

Mailing address

6300 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-8935

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00065073WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1261440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261440000000",
    "number": "1053640045",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6300 E LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980298935"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6300 E LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980298935",
            "telephone_number": "425-369-0265"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAVISHANKAR",
        "first_name": "JYOTSNA",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-12-22",
        "last_updated": "2009-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00065073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Dec 22, 2009; 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.