Individual provider Active NPI

Spencer Rommel Knudson, PHARMD

  • Pharmacist
  • Tacoma, WA
National Provider Identifier
1285417824
Registry record updated Aug 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH61458915 Issued in WA
Practice address
315 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Phone
(253) 403-2405
NPI assigned
Aug 17, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 17, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH61458915 WA Primary

Addresses

Primary practice location

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234

Mailing address

315 Martin Luther King Jr Way
Tacoma, WA 98405-4234

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH61458915WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1692230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692230400000",
    "number": "1285417824",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "315 MARTIN LUTHER KING JR WAY",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984054234",
            "telephone_number": "253-403-2405"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KNUDSON",
        "first_name": "SPENCER",
        "middle_name": "ROMMEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-17",
        "last_updated": "2023-08-17",
        "certification_date": "2023-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61458915",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 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.

Verify at the official NPI Registry.