Active NPI
Hima Gorantla
- Pharmacist
- Arlington, WA
National Provider Identifier
1194127266
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00054737
- Practice address
- 4010 172ND St NE
Arlington, WA 98223-8482 - Phone
- (360) 386-4615
- Fax
- (360) 386-4609
- NPI assigned
- Sep 20, 2014
- Last updated
- Sep 20, 2014
- 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 | PH00054737 | WA | Primary |
Addresses
Primary practice location
4010 172ND St NE
Arlington, WA 98223-8482
Mailing address
3721 222ND PL SE
Bothell, WA 98021-4221
Phone (360) 386-4615
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 |
|---|---|---|---|
| PH00054737 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1411171200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1411171200000",
"number": "1194127266",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3721 222ND PL SE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980214221",
"telephone_number": "360-386-4615",
"fax_number": "360-386-4609"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4010 172ND ST NE",
"city": "ARLINGTON",
"state": "WA",
"postal_code": "982238482",
"telephone_number": "360-386-4615",
"fax_number": "360-386-4609"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GORANTLA",
"first_name": "HIMA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2014-09-20",
"last_updated": "2014-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00054737",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Arlington, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.