Madrona Health, LLC

Primary specialty

PharmacyTaxonomy code 333600000X

License

CF60796655 Issued in WA

Legal business name

MADRONA HEALTH, LLC

Practice address

5959 Corson Ave S Ste C-1
Seattle, WA 98108-2605

Phone

(206) 341-3300

Fax

(206) 341-3329

NPI assigned

Sep 13, 2017

Organization subpart

No

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

Authorized official

Name

Hung Van Truong, PHARMD, MBANPI 1245217538

Title

Executive Director

Phone

(206) 341-3300

Specialties & licenses 2

Addresses

Other identifiers 1

Other names 2

• Madrona Pharmacy Doing business as
• Virginia Mason Georgetown Pharmacy Other name

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

Medicare medical equipment & supply locations

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• Virginia Mason Medical Center

  • Neurological Surgery Physician
  • Seattle, WA
  • NPI 1487701991

  Member Of

  NPD member

Locations

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Hung Van Truong, PHARMD

  • Pharmacist
  • Seattle, WA
  • NPI 1245217538
  NPD Authorized official
• Anne Marie Mariko Mock, PHARM.D.

  • Pharmacist
  • Seattle, WA
  • NPI 1285964973
  NPD
• Kristine Crawford, PHARMD

  • Pharmacist
  • Seattle, WA
  • NPI 1568961159
  NPD (past)

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

{
    "created_epoch": "1505260800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1678233600000",
    "number": "1306365184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5959 CORSON AVE S STE C-1",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981082605",
            "telephone_number": "206-341-3300",
            "fax_number": "206-341-3329"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5959 CORSON AVE S STE C-1",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981082605",
            "telephone_number": "206-341-3300",
            "fax_number": "206-341-3329"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MADRONA HEALTH, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-09-13",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A",
        "authorized_official_last_name": "TRUONG",
        "authorized_official_first_name": "HUNG",
        "authorized_official_middle_name": "VAN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "206-341-3300",
        "authorized_official_credential": "PHARMD, MBA"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "CF60796655",
            "primary": true
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "AK",
            "license": "132192",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2171441",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Madrona Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Virginia Mason Georgetown Pharmacy",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Madison Park Pharmacy and Wellness Center LLC
• Madison Tower Plastic Surgery
• Trilisa Madison, ND
• Charles Madrid I, RN
• Madrona Clinics, PLLC
• Asha Amber Lynn Madsen-Humeniuk, PSYD, LP
• Priscilla M Madsen, M.D.
• Tara J Madsen
• David K Madtes
• Mutinta Madubansi-Kawinga, NURSE PRACTITIONER

• Pharmacy in Seattle, WA
• Providers in Seattle, WA by specialty
• Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.