Allen John Engberg, RPH
Individual provider Active NPI Pharmacist · Orting, WA
NPI 1306148044 · NPPES record last updated Dec 1, 2010
Key facts
- NPI
- 1306148044
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- PH00021152 (WA)
- Practice address
- 215 Whitesell St NW
Orting, WA 98360-9329 - Phone
- (360) 893-0843
- NPI assigned
- Dec 1, 2010
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00021152 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Safeway Inc | Past | Accepting new patients | |
| Safeway Inc | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00021152 | WA | Yes |
Addresses
Primary practice location
215 Whitesell St NW
Orting, WA 98360-9329
Mailing address
215 Whitesell St NW
Orting, WA 98360
Phone (360) 893-0843
Other providers in Orting, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 1, 2010. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.