NPIMap

Individual provider Active NPI

Fang Fang, RPH/PHD

  • Pharmacist
  • Kent, WA
National Provider Identifier
1093016644
Registry record updated Nov 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60133101 Issued in WA
Practice address
210 Washington Ave S
Kent, WA 98032-5721
Phone
(253) 852-5115
NPI assigned
Nov 13, 2010
Last updated
Nov 13, 2010By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60133101 WA Primary

Addresses

Primary practice location

210 Washington Ave S
Kent, WA 98032-5721

Mailing address

210 Washington Ave S
Kent, WA 98032-5721
Phone (253) 852-5115

Other names 1

  • Sophia Fang Other name

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 Philosophy, Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH60133101WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients
Safeway 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": "1289606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1289606400000",
    "number": "1093016644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 WASHINGTON AVE S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325721",
            "telephone_number": "253-852-5115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 WASHINGTON AVE S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980325721",
            "telephone_number": "253-852-5115"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FANG",
        "first_name": "FANG",
        "name_prefix": "Dr.",
        "credential": "RPH/PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-11-13",
        "last_updated": "2010-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60133101",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SOPHIA",
            "last_name": "FANG",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2010; 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.