Active NPI
Lai Phuc Phan, PHARMD
- Pharmacist
- Burien, WA
National Provider Identifier
1225464936
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60393203
- Practice address
- 16251 Sylvester Rd SW
Burien, WA 98166-3017 - Phone
- (206) 244-9970
- NPI assigned
- Sep 26, 2013
- 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 | PH60393203 | WA | Primary |
Addresses
Primary practice location
16251 Sylvester Rd SW
Burien, WA 98166-3017
Mailing address
13804 29TH Ave S
Seatac, WA 98168-3852
Phone (206) 619-6848
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH60393203 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1380153600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1380153600000",
"number": "1225464936",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13804 29TH AVE S",
"city": "SEATAC",
"state": "WA",
"postal_code": "981683852",
"telephone_number": "206-619-6848"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "16251 SYLVESTER RD SW",
"city": "BURIEN",
"state": "WA",
"postal_code": "981663017",
"telephone_number": "206-244-9970"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHAN",
"first_name": "LAI",
"middle_name": "PHUC",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-09-26",
"last_updated": "2013-09-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60393203",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Burien, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.