Active NPI
Wade Whitman, B.PHARM
- Pharmacist
- Kennewick, WA
National Provider Identifier
1063786820
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00017700
- Practice address
- 2811 W 10TH Ave
Kennewick, WA 99336-3104 - Phone
- (509) 735-8733
- NPI assigned
- Feb 25, 2012
- Last updated
- Feb 25, 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 | PH00017700 | WA | Primary |
Addresses
Primary practice location
2811 W 10TH Ave
Kennewick, WA 99336-3104
Mailing address
3107 S Dawes St
Kennewick, WA 99338-2706
Phone (509) 945-7744
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 |
|---|---|---|---|
| PH00017700 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1330128000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1330128000000",
"number": "1063786820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3107 S DAWES ST",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993382706",
"telephone_number": "509-945-7744"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2811 W 10TH AVE",
"city": "KENNEWICK",
"state": "WA",
"postal_code": "993363104",
"telephone_number": "509-735-8733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WHITMAN",
"first_name": "WADE",
"credential": "B.PHARM",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-25",
"last_updated": "2012-02-25",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00017700",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kennewick, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 25, 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.