Individual provider Active NPI

Tracey Tram Luong, PHARM. D

  • Pharmacist
  • Shoreline, WA
National Provider Identifier
1205112703
Registry record updated Oct 27, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH000040395 Issued in WA
Practice address
1175 N 205TH St
Shoreline, WA 98133-3206
Phone
(206) 542-0497
Fax
(206) 546-1167
NPI assigned
Oct 27, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 27, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH000040395 WA Primary

Addresses

Primary practice location

1175 N 205TH St
Shoreline, WA 98133-3206

Mailing address

1175 N 205TH St
Shoreline, WA 98133-3206
Phone (206) 542-0497

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH000040395WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1319673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1319673600000",
    "number": "1205112703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1175 N 205TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333206",
            "telephone_number": "206-542-0497",
            "fax_number": "206-546-1167"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1175 N 205TH ST",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981333206",
            "telephone_number": "206-542-0497",
            "fax_number": "206-546-1167"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUONG",
        "first_name": "TRACEY",
        "middle_name": "TRAM",
        "name_prefix": "Ms.",
        "credential": "PHARM. D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-10-27",
        "last_updated": "2011-10-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH000040395",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 27, 2011; 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.