Active NPI
Alykyhan Sadrudin Rajan, RPH
- Pharmacist
- Everett, WA
National Provider Identifier
1063785012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00041807
- Practice address
- 12906 Bothell Everett Hwy
Everett, WA 98208-6687 - Phone
- (425) 357-2033
- NPI assigned
- Feb 21, 2012
- Last updated
- Feb 21, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | PH00041807 | WA | Primary |
Addresses
Primary practice location
12906 Bothell Everett Hwy
Everett, WA 98208-6687
Mailing address
18111 96TH Ave NE Apt 203
Bothell, WA 98011-3352
Phone (206) 234-8433
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH00041807 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Meyer Stores Inc. | Past | Accepting new patients | |
| Fred Meyer Stores Inc | Past | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329782400000",
"number": "1063785012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "18111 96TH AVE NE APT 203",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980113352",
"telephone_number": "206-234-8433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "12906 BOTHELL EVERETT HWY",
"city": "EVERETT",
"state": "WA",
"postal_code": "982086687",
"telephone_number": "425-357-2033"
}
],
"practiceLocations": [],
"basic": {
"last_name": "RAJAN",
"first_name": "ALYKYHAN",
"middle_name": "SADRUDIN",
"credential": "RPH",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-21",
"last_updated": "2012-02-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00041807",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.