Active NPI
Justin Sang Seo, PHARMD
- Pharmacist
- Union Gap, WA
National Provider Identifier
1245894302
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60886076
- Practice address
- 2519 Main St
Union Gap, WA 98903-1605 - Phone
- (509) 453-3603
- NPI assigned
- Apr 24, 2019
- Last updated
- Apr 24, 2019
- Sex
- Male
- Sole proprietor
- Yes
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 | PH60886076 | WA | Primary |
Addresses
Primary practice location
2519 Main St
Union Gap, WA 98903-1605
Mailing address
4010 W Chestnut Ave # a
Yakima, WA 98908-3251
Phone (808) 256-7261
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 |
|---|---|---|---|
| PH60886076 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556064000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556064000000",
"number": "1245894302",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4010 W CHESTNUT AVE # A",
"city": "YAKIMA",
"state": "WA",
"postal_code": "989083251",
"telephone_number": "808-256-7261"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2519 MAIN ST",
"city": "UNION GAP",
"state": "WA",
"postal_code": "989031605",
"telephone_number": "509-453-3603"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SEO",
"first_name": "JUSTIN",
"middle_name": "SANG",
"name_prefix": "Dr.",
"credential": "PHARMD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2019-04-24",
"last_updated": "2019-04-24",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60886076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Union Gap, WA
- Maria Salazar
- Kimberly G Sales, ARNP
- Alicia Sanchez
- Donald Thomas Schrack, D.D.S.
- Ronald Spencer Senn, DDS
- SHC Medical Center Toppenish (Astria Health Center)
- Shopko Stores Operating Co LLC (ShopKo Pharmacy 073)
- Shopko Stores Operating Co. LLC (ShopKo Optical 073)
- Shoptikal LLC (Shopko Optical 4073)
- Betty Simmons, CCC-SLP
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.