Individual provider Active NPI

Kerolos Adel Y Soliman

  • Pharmacist
  • Lynnwood, WA
National Provider Identifier
1174973465
Registry record updated Jun 16, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
IR60310147 Issued in WA
Practice address
14912 17TH PL W
Lynnwood, WA 98087-8795
Phone
(206) 383-5561
NPI assigned
Jun 16, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X IR60310147 WA Primary

Addresses

Primary practice location

14912 17TH PL W
Lynnwood, WA 98087-8795

Mailing address

14912 17TH PL W
Lynnwood, WA 98087-8795
Phone (206) 383-5561

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
IR60310147WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1466035200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466035200000",
    "number": "1174973465",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14912 17TH PL W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980878795",
            "telephone_number": "206-383-5561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14912 17TH PL W",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980878795",
            "telephone_number": "206-383-5561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOLIMAN",
        "first_name": "KEROLOS",
        "middle_name": "ADEL Y",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-16",
        "last_updated": "2016-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "IR60310147",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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 Jun 16, 2016; 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.