Individual provider Active NPI

Ma Jerrylinn Ocampo Tanjutco

  • Pharmacist
  • Battle Ground, WA
National Provider Identifier
1184956112
Registry record updated Feb 1, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60022930 Issued in WA
Practice address
808 W Main St
Battle Ground, WA 98604-9136
Phone
(360) 687-5136
Fax
(360) 687-5186
NPI assigned
Feb 1, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 1, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60022930 WA Primary

Addresses

Primary practice location

808 W Main St
Battle Ground, WA 98604-9136

Mailing address

808 W Main St
Battle Ground, WA 98604-9136
Phone (360) 687-5136

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
PH60022930WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1264982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1264982400000",
    "number": "1184956112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "808 W MAIN ST",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049136",
            "telephone_number": "360-687-5136",
            "fax_number": "360-687-5186"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "808 W MAIN ST",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986049136",
            "telephone_number": "360-687-5136",
            "fax_number": "360-687-5186"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANJUTCO",
        "first_name": "MA JERRYLINN",
        "middle_name": "OCAMPO",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-02-01",
        "last_updated": "2010-02-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60022930",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Battle Ground, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 1, 2010; 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.