Active NPI
Brian Joseph Keown
- Pharmacist
- Sedro Woolley, WA
National Provider Identifier
1245709898
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00013683
- Practice address
- 640 State Route 20 Unit a
Sedro Woolley, WA 98284-4315 - Phone
- (360) 503-1676
- Fax
- (360) 503-1677
- NPI assigned
- Nov 13, 2018
- Last updated
- Nov 13, 2018
- 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 | PH00013683 | WA | Primary |
Addresses
Primary practice location
640 State Route 20 Unit a
Sedro Woolley, WA 98284-4315
Mailing address
640 State Route 20 Unit a
Sedro Woolley, WA 98284-4315
Phone (360) 503-1676
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 |
|---|---|---|---|
| PH00013683 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Highway 20 Hometown Pharmacy LLC | Past | Accepting new patients |
Organizations & group practices 1
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": "1542067200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1542067200000",
"number": "1245709898",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "640 STATE ROUTE 20 UNIT A",
"city": "SEDRO WOOLLEY",
"state": "WA",
"postal_code": "982844315",
"telephone_number": "360-503-1676",
"fax_number": "360-503-1677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "640 STATE ROUTE 20 UNIT A",
"city": "SEDRO WOOLLEY",
"state": "WA",
"postal_code": "982844315",
"telephone_number": "360-503-1676",
"fax_number": "360-503-1677"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KEOWN",
"first_name": "BRIAN",
"middle_name": "JOSEPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-13",
"last_updated": "2018-11-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00013683",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedro Woolley, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 13, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.