Individual provider Active NPI

Khoa Cong Le

  • Pharmacist
  • Redmond, WA
National Provider Identifier
1275290116
Registry record updated Nov 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH61082385 Issued in WA
Practice address
4124 148TH Ave NE
Redmond, WA 98052-5164
Phone
(425) 968-8766
NPI assigned
Nov 28, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH61082385 WA Primary

Addresses

Primary practice location

4124 148TH Ave NE
Redmond, WA 98052-5164

Mailing address

5071 Mithun PL NE
Seattle, WA 98105-2951
Phone (360) 359-0307

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
PH61082385WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1638057600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1638057600000",
    "number": "1275290116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5071 MITHUN PL NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981052951",
            "telephone_number": "360-359-0307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4124 148TH AVE NE",
            "city": "REDMOND",
            "state": "WA",
            "postal_code": "980525164",
            "telephone_number": "425-968-8766"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LE",
        "first_name": "KHOA",
        "middle_name": "CONG",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-11-28",
        "last_updated": "2021-11-28",
        "certification_date": "2021-11-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61082385",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Redmond, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 28, 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.

Verify at the official NPI Registry.