Active NPI
Raven Symone Conyers
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- Everett, WA
National Provider Identifier
1245953553
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
- License
- PH61183732
- 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
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 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
| License | State | Type | Specialty |
|---|---|---|---|
| PH61183732 | WA | MD | Pharmacist 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.