Individual provider Active NPI

Janet Irene Black, PHARMACIST

  • Pharmacist
  • Lynnwood, WA
National Provider Identifier
1104075589
Registry record updated Sep 10, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH000010498 Issued in WA
Practice address
19401 40TH Avenue West
Suite 330 Career Staff Unlimited
Lynnwood, WA 98036
Phone
(800) 766-0122
Fax
(866) 835-5848
NPI assigned
Sep 10, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2008

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH000010498 WA Primary

Addresses

Primary practice location

19401 40TH Avenue West
Suite 330 Career Staff Unlimited
Lynnwood, WA 98036

Mailing address

4626 244TH PL SE
Issaquah, WA 98029
Phone (425) 891-6657

Other identifiers 1

IdentifierTypeStateIssuer
PH00010498OtherWAPHARMACIST LICENSE

Other names 1

  • Janet Irene Brakebill Former 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

State licenses

LicenseStateTypeSpecialty
PH000010498WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1221004800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221004800000",
    "number": "1104075589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4626 244TH PL SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "98029",
            "telephone_number": "425-891-6657"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19401 40TH AVENUE WEST",
            "address_2": "SUITE 330 CAREER STAFF UNLIMITED",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98036",
            "telephone_number": "800-766-0122",
            "fax_number": "866-835-5848"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BLACK",
        "first_name": "JANET",
        "middle_name": "IRENE",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-09-10",
        "last_updated": "2008-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH000010498",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PH00010498",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JANET",
            "last_name": "BRAKEBILL",
            "middle_name": "IRENE",
            "credential": "PHARMACIST",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2008; 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.