Individual provider Active NPI

Leslie Brandt Hanson, PHARMACIST

  • Pharmacist
  • Arlington, WA
National Provider Identifier
1093900565
Registry record updated Sep 7, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00011491 Issued in WA
Practice address
330 S Stillaguamish Ave
Arlington, WA 98223-1642
Phone
(360) 435-2133
Fax
(360) 403-4122
NPI assigned
Sep 7, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 7, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00011491 WA Primary

Addresses

Primary practice location

330 S Stillaguamish Ave
Arlington, WA 98223-1642

Mailing address

330 S Stillaguamish Ave
Arlington, WA 98223-1642
Phone (360) 435-2133

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
PH00011491WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189123200000",
    "number": "1093900565",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "330 S STILLAGUAMISH AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231642",
            "telephone_number": "360-435-2133",
            "fax_number": "360-403-4122"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "330 S STILLAGUAMISH AVE",
            "city": "ARLINGTON",
            "state": "WA",
            "postal_code": "982231642",
            "telephone_number": "360-435-2133",
            "fax_number": "360-403-4122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HANSON",
        "first_name": "LESLIE",
        "middle_name": "BRANDT",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00011491",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Arlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; 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.