Active NPI
Brandon Ige
- Pharmacist
- Mountlake Terrace, WA
National Provider Identifier
1053712869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60470581
- Practice address
- 22803 44TH Ave W
Mountlake Terrace, WA 98043-5032 - Phone
- (425) 771-3738
- Fax
- (425) 776-1190
- NPI assigned
- Sep 11, 2014
- 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 | PH60470581 | WA | Primary |
Addresses
Primary practice location
22803 44TH Ave W
Mountlake Terrace, WA 98043-5032
Mailing address
23028 100TH Ave W
Edmonds, WA 98020-5080
Phone (425) 670-2860
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 |
|---|---|---|---|
| PH60470581 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1410393600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1777075200000",
"number": "1053712869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "23028 100TH AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980205080",
"telephone_number": "425-670-2860"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22803 44TH AVE W",
"city": "MOUNTLAKE TERRACE",
"state": "WA",
"postal_code": "980435032",
"telephone_number": "425-771-3738",
"fax_number": "425-776-1190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "IGE",
"first_name": "BRANDON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-09-11",
"last_updated": "2026-04-25",
"certification_date": "2026-04-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60470581",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mountlake Terrace, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 25, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.