Individual provider Active NPI

Gwen Nance, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Seattle, WA
National Provider Identifier
1073093423
Registry record updated Aug 15, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PH60774782 Issued in WA
Practice address
4800 Sand Point Way NE
Seattle, WA 98105-3901
Phone
(206) 987-2033
Fax
(206) 987-2597
NPI assigned
Aug 15, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2018

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 18867 AL
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH029223 GA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH60774782 WA Primary

Addresses

Primary practice location

4800 Sand Point Way NE
Seattle, WA 98105-3901

Mailing address

4800 Sand Point Way NE
M/S MB.5.420
Seattle, WA 98105-3901
Phone (206) 987-2033

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
18867ALMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH029223GAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PH60774782WAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1534291200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1534291200000",
    "number": "1073093423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "address_2": "M/S MB.5.420",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2033",
            "fax_number": "206-987-2597"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4800 SAND POINT WAY NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981053901",
            "telephone_number": "206-987-2033",
            "fax_number": "206-987-2597"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NANCE",
        "first_name": "GWEN",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-08-15",
        "last_updated": "2018-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "AL",
            "license": "18867",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "GA",
            "license": "RPH029223",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH60774782",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2018; 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.