Individual provider Active NPI

Ryan Erlewine

  • Pharmacist
  • Camas, WA
National Provider Identifier
1134486103
Registry record updated Apr 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60021512 Issued in WA
Practice address
3210 NW Grass Valley Dr
Camas, WA 98607-4001
Phone
(509) 969-5175
NPI assigned
Apr 16, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 16, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60021512 WA Primary

Addresses

Primary practice location

3210 NW Grass Valley Dr
Camas, WA 98607-4001

Mailing address

3210 NW Grass Valley Dr
Camas, WA 98607-4001
Phone (509) 969-5175

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
PH60021512WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1334534400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1334534400000",
    "number": "1134486103",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3210 NW GRASS VALLEY DR",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986074001",
            "telephone_number": "509-969-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3210 NW GRASS VALLEY DR",
            "city": "CAMAS",
            "state": "WA",
            "postal_code": "986074001",
            "telephone_number": "509-969-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ERLEWINE",
        "first_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-04-16",
        "last_updated": "2012-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60021512",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Camas, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 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.

Verify at the official NPI Registry.