Individual provider Active NPI

Jack Miller Hamilton Jr., PHARMD, MBA

  • Pharmacist
  • Tacoma, WA
National Provider Identifier
1295002962
Registry record updated May 15, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60680447 Issued in WA
Practice address
5921 Indian TRL NE
Tacoma, WA 98422-4212
Phone
(773) 710-8290
NPI assigned
Nov 23, 2011
Last updated
May 15, 2025By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61133 CA
Pharmacist 183500000X PH60680447 WA Primary

Addresses

Primary practice location

5921 Indian TRL NE
Tacoma, WA 98422-4212

Mailing address

5921 Indian TRL NE
Tacoma, WA 98422-4212
Phone (773) 710-8290

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
Master of Business Administration, Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
61133CAMDPharmacist
PH60680447WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1322006400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747267200000",
    "number": "1295002962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5921 INDIAN TRL NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984224212",
            "telephone_number": "773-710-8290"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5921 INDIAN TRL NE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984224212",
            "telephone_number": "773-710-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAMILTON",
        "first_name": "JACK",
        "middle_name": "MILLER",
        "name_prefix": "Dr.",
        "name_suffix": "Jr.",
        "credential": "PHARMD, MBA",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-11-23",
        "last_updated": "2025-05-15",
        "certification_date": "2025-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "61133",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60680447",
            "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 May 15, 2025; 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.