Individual provider Active NPI

Richard Loren Nelson, R PH

  • Pharmacist
  • Sunnyside, WA
National Provider Identifier
1205965845
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00007504 Issued in WA
Practice address
2010 Yakima Valley Hwy Ste C1
Sunnyside, WA 98944-1289
Phone
(509) 893-2711
Fax
(509) 839-4768
NPI assigned
Mar 2, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00007504 WA Primary

Addresses

Primary practice location

2010 Yakima Valley Hwy Ste C1
Sunnyside, WA 98944-1289

Mailing address

172702 W Byron Rd
Prosser, WA 99350-8544
Phone (509) 786-3237

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
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
PH00007504WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1172793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1205965845",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "172702 W BYRON RD",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993508544",
            "telephone_number": "509-786-3237"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2010 YAKIMA VALLEY HWY STE C1",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989441289",
            "telephone_number": "509-893-2711",
            "fax_number": "509-839-4768"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "RICHARD",
        "middle_name": "LOREN",
        "name_prefix": "Mr.",
        "credential": "R PH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-03-02",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00007504",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.