Active NPI
Sucheta Suthar
- Pharmacist
- Edmonds, WA
National Provider Identifier
1104187301
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 69398
- Practice address
- 22828 100TH Ave W
Edmonds, WA 98020-5920 - Phone
- (425) 778-2144
- Fax
- (425) 771-5420
- NPI assigned
- Jun 4, 2012
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 69398 | WA | Primary |
Addresses
Primary practice location
22828 100TH Ave W
Edmonds, WA 98020-5920
Mailing address
22828 100TH Ave W
Edmonds, WA 98020-5920
Phone (425) 778-2144
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 910849764 | Medicaid | WA |
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 |
|---|---|---|---|
| 69398 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1338768000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1338768000000",
"number": "1104187301",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "22828 100TH AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980205920",
"telephone_number": "425-778-2144",
"fax_number": "425-771-5420"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "22828 100TH AVE W",
"city": "EDMONDS",
"state": "WA",
"postal_code": "980205920",
"telephone_number": "425-778-2144",
"fax_number": "425-771-5420"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SUTHAR",
"first_name": "SUCHETA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-04",
"last_updated": "2012-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "69398",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "910849764",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Edmonds, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 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.