Active NPI
Daniel R Bonogofski, REG. PHARMACIST
- Pharmacist
- Spokane, WA
National Provider Identifier
1104160696
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- P00007966
- Practice address
- 104 W 5TH Ave
Spokane, WA 99204-4880 - Phone
- (509) 474-2232
- Fax
- (509) 474-2233
- NPI assigned
- Nov 21, 2012
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | P00007966 | WA | Primary |
| Pharmacotherapy Pharmacist | 1835P1200X | P00007966 | WA |
Addresses
Primary practice location
104 W 5TH Ave
Spokane, WA 99204-4880
Mailing address
104 W 5TH Ave
Spokane, WA 99204-4880
Phone (509) 474-2232
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 |
|---|---|---|---|
| P00007966 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1353456000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353456000000",
"number": "1104160696",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 W 5TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992044880",
"telephone_number": "509-474-2232",
"fax_number": "509-474-2233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "104 W 5TH AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992044880",
"telephone_number": "509-474-2232",
"fax_number": "509-474-2233"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONOGOFSKI",
"first_name": "DANIEL",
"middle_name": "R",
"credential": "REG. PHARMACIST",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-11-21",
"last_updated": "2012-11-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "P00007966",
"primary": true
},
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "WA",
"license": "P00007966",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.