Active NPI
Dongkoo Khang
- Pharmacist
- Grandview, WA
National Provider Identifier
1275200222
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- IR61182985
- Practice address
- 610 E Wine Country Rd
Grandview, WA 98930-1062 - Phone
- (509) 882-1060
- NPI assigned
- Aug 26, 2021
- Last updated
- Aug 26, 2021
- 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 | IR61182985 | WA | Primary |
Addresses
Primary practice location
610 E Wine Country Rd
Grandview, WA 98930-1062
Mailing address
610 E Wine Country Rd
Grandview, WA 98930-1062
Phone (509) 882-1060
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 |
|---|---|---|---|
| IR61182985 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Organizations & group practices 2
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": "1629936000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629936000000",
"number": "1275200222",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "610 E WINE COUNTRY RD",
"city": "GRANDVIEW",
"state": "WA",
"postal_code": "989301062",
"telephone_number": "509-882-1060"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "610 E WINE COUNTRY RD",
"city": "GRANDVIEW",
"state": "WA",
"postal_code": "989301062",
"telephone_number": "509-882-1060"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KHANG",
"first_name": "DONGKOO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2021-08-26",
"last_updated": "2021-08-26",
"certification_date": "2021-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "IR61182985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Grandview, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.