Active NPI
Man Ha
- Pharmacist
- Walla Walla, WA
National Provider Identifier
1265205595
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH61451761
- Practice address
- 401 W Poplar St
Walla Walla, WA 99362-2846 - Phone
- (509) 897-2696
- NPI assigned
- Oct 30, 2023
- 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 | PH61451761 | WA | Primary |
Addresses
Primary practice location
401 W Poplar St
Walla Walla, WA 99362-2846
Mailing address
336 S Palouse St Apt 3
Walla Walla, WA 99362-3045
Phone (518) 645-2235
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 |
|---|---|---|---|
| PH61451761 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1698624000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1698624000000",
"number": "1265205595",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "336 S PALOUSE ST APT 3",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993623045",
"telephone_number": "518-645-2235"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "401 W POPLAR ST",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622846",
"telephone_number": "509-897-2696"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HA",
"first_name": "MAN",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-10-30",
"last_updated": "2023-10-30",
"certification_date": "2023-10-30",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH61451761",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.