NPIMap

Individual provider Active NPI

Jessica M Lichtenstein, PHARMD.

  • Pharmacist
  • Kirkland, WA
National Provider Identifier
1295035087
Registry record updated Apr 11, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60154387 Issued in WA
Practice address
14444 124TH Ave NE
Kirkland, WA 98034-4801
Phone
(425) 821-7455
Fax
(425) 820-6384
NPI assigned
Oct 26, 2010
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 11, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60154387 WA Primary

Addresses

Primary practice location

14444 124TH Ave NE
Kirkland, WA 98034-4801

Mailing address

14444 124TH Ave NE
Kirkland, WA 98034-4801
Phone (425) 821-7455

Other names 1

  • Jessica M Korsten Former name

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
PH60154387WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1288051200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1491868800000",
    "number": "1295035087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14444 124TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344801",
            "telephone_number": "425-821-7455",
            "fax_number": "425-820-6384"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14444 124TH AVE NE",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980344801",
            "telephone_number": "425-821-7455",
            "fax_number": "425-820-6384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LICHTENSTEIN",
        "first_name": "JESSICA",
        "middle_name": "M",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-10-26",
        "last_updated": "2017-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60154387",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JESSICA",
            "last_name": "KORSTEN",
            "middle_name": "M",
            "credential": "PHARMD.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; 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.