Active NPI
Bob Daniel
- Pharmacist
- Walla Walla, WA
National Provider Identifier
1205136579
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00045289
- Practice address
- 1120 W Rose St
Walla Walla, WA 99362-1662 - Phone
- (509) 525-6695
- Fax
- (509) 522-2349
- NPI assigned
- Nov 2, 2010
- Last updated
- Nov 28, 2017
- Sex
- Male
- 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 | PH00045289 | WA | Primary |
Addresses
Primary practice location
1120 W Rose St
Walla Walla, WA 99362-1662
Mailing address
1120 W Rose St
Walla Walla, WA 99362-1662
Phone (509) 525-6695
Other practice location 1
1600 Plaza Way
Walla Walla, WA 99362-4325
Phone (509) 522-4672
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 |
|---|---|---|---|
| PH00045289 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288656000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1511827200000",
"number": "1205136579",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1120 W ROSE ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993621662",
"telephone_number": "509-525-6695",
"fax_number": "509-522-2349"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1120 W ROSE ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993621662",
"telephone_number": "509-525-6695",
"fax_number": "509-522-2349"
}
],
"practiceLocations": [
{
"address_1": "1600 Plaza Way",
"address_purpose": "LOCATION",
"city": "Walla Walla",
"state": "WA",
"postal_code": "993624325",
"country_code": "US",
"telephone_number": "509-522-4672",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "DANIEL",
"first_name": "BOB",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-11-02",
"last_updated": "2017-11-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00045289",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.