Individual provider Active NPI

Tsega Temo

  • Pharmacist
  • Vancouver, WA
National Provider Identifier
1083499115
Registry record updated Aug 28, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH61304945 Issued in WA
Practice address
1325 E Mill Plain Blvd Ste C8
Vancouver, WA 98663
Phone
(971) 419-3447
NPI assigned
Aug 28, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 28, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH61304945 WA Primary

Addresses

Primary practice location

1325 E Mill Plain Blvd Ste C8
Vancouver, WA 98663

Mailing address

13215 SE Mill Plain Blvd Ste C8
Vancouver, WA 98684-6999
Phone (971) 419-3447

Other practice location 1

3505 SE 192nd Ave
Vancouver, WA 98683-1436
Phone (360) 253-3043

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

LicenseStateTypeSpecialty
PH61304945WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1693180800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693180800000",
    "number": "1083499115",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13215 SE MILL PLAIN BLVD STE C8",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986846999",
            "telephone_number": "971-419-3447"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 E MILL PLAIN BLVD STE C8",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "98663",
            "telephone_number": "971-419-3447"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3505 SE 192nd Ave",
            "address_purpose": "LOCATION",
            "city": "Vancouver",
            "state": "WA",
            "postal_code": "986831436",
            "country_code": "US",
            "telephone_number": "360-253-3043",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TEMO",
        "first_name": "TSEGA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-08-28",
        "last_updated": "2023-08-28",
        "certification_date": "2023-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61304945",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vancouver, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2023; 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.