Active NPI
Susan Fellows, RPH
- Pharmacist
- Puyallup, WA
National Provider Identifier
1154684033
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 11361
- Practice address
- 11012 Canyon Rd E
Puyallup, WA 98373-4200 - Phone
- (253) 537-3808
- Fax
- (253) 539-3654
- NPI assigned
- Jun 16, 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 | 11361 | WA | Primary |
Addresses
Primary practice location
11012 Canyon Rd E
Puyallup, WA 98373-4200
Mailing address
11012 Canyon Rd E
Puyallup, WA 98373-4200
Phone (253) 537-3808
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
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11361 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1339804800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1339804800000",
"number": "1154684033",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11012 CANYON RD E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983734200",
"telephone_number": "253-537-3808",
"fax_number": "253-539-3654"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "11012 CANYON RD E",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983734200",
"telephone_number": "253-537-3808",
"fax_number": "253-539-3654"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FELLOWS",
"first_name": "SUSAN",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-06-16",
"last_updated": "2012-06-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "11361",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Puyallup, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 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.