Individual provider Active NPI

Raven Symone Conyers

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Everett, WA
National Provider Identifier
1245953553
Registry record updated Jun 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PH61183732 Issued in WA
Practice address
2615 Broadway
Everett, WA 98201-3044
Phone
(425) 259-6262
Fax
(425) 258-1485
NPI assigned
Sep 21, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 6, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH61183732 WA Primary

Addresses

Primary practice location

2615 Broadway
Everett, WA 98201-3044

Mailing address

2615 Broadway
Everett, WA 98201-3044
Phone (425) 259-6262

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

LicenseStateTypeSpecialty
PH61183732WAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1663718400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780704000000",
    "number": "1245953553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2615 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013044",
            "telephone_number": "425-259-6262",
            "fax_number": "425-258-1485"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2615 BROADWAY",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982013044",
            "telephone_number": "425-259-6262",
            "fax_number": "425-258-1485"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONYERS",
        "first_name": "RAVEN",
        "middle_name": "SYMONE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-21",
        "last_updated": "2026-06-06",
        "certification_date": "2026-06-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH61183732",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 6, 2026; 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.