Active NPI
Jessica Shin
- Pharmacist
- Marysville, WA
National Provider Identifier
1073330650
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH61279969
- Practice address
- 8713 64TH St NE
Marysville, WA 98270-7704 - Phone
- (360) 386-3011
- NPI assigned
- Sep 24, 2024
- Last updated
- Aug 28, 2026
- Sex
- Female
- 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 | PH61279969 | WA | Primary |
Addresses
Primary practice location
8713 64TH St NE
Marysville, WA 98270-7704
Mailing address
8713 64TH St NE
Marysville, WA 98270-7704
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 |
|---|---|---|---|
| PH61279969 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1727136000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787875200000",
"number": "1073330650",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8713 64TH ST NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982707704"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8713 64TH ST NE",
"city": "MARYSVILLE",
"state": "WA",
"postal_code": "982707704",
"telephone_number": "360-386-3011"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIN",
"first_name": "JESSICA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-09-24",
"last_updated": "2026-08-28",
"certification_date": "2026-08-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH61279969",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Marysville, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 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.