Active NPI
Victoria Ann Jimmicum
- Pharmacy Technician
- Neah Bay, WA
National Provider Identifier
1306187497
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- VA60214288
- Practice address
- 250 Fort Street
Neah Bay, WA 98357 - Phone
- (360) 645-2445
- NPI assigned
- Mar 14, 2013
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | VA60214288 | WA | Primary |
Addresses
Primary practice location
250 Fort Street
Neah Bay, WA 98357
Mailing address
PO Box 273
Neah Bay, WA 98357-0273
Phone (360) 640-4200
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
| License | State | Type | Specialty |
|---|---|---|---|
| VA60214288 | WA | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1363219200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1363219200000",
"number": "1306187497",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 273",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "983570273",
"telephone_number": "360-640-4200"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "250 FORT STREET",
"city": "NEAH BAY",
"state": "WA",
"postal_code": "98357",
"telephone_number": "360-645-2445"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JIMMICUM",
"first_name": "VICTORIA",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-03-14",
"last_updated": "2013-03-14",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "WA",
"license": "VA60214288",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Neah Bay, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.