Individual provider Active NPI

Gloria H Angelo, PHARM-D

  • Pharmacist
  • Nespelem, WA
National Provider Identifier
1306993662
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00015647 Issued in WA
Practice address
29 Nespelem-Sanpoil
Agency Campus
Nespelem, WA 99155
Phone
(509) 422-7735
Fax
(509) 422-7738
NPI assigned
Jan 5, 2007
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00015647 WA Primary

Addresses

Primary practice location

29 Nespelem-Sanpoil
Agency Campus
Nespelem, WA 99155

Mailing address

12056 Hwy 21
Keller, WA 99140-2056
Phone (509) 634-4430

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
PH00015647WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1167955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1306993662",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12056 HWY 21",
            "city": "KELLER",
            "state": "WA",
            "postal_code": "991402056",
            "telephone_number": "509-634-4430"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 NESPELEM-SANPOIL",
            "address_2": "AGENCY CAMPUS",
            "city": "NESPELEM",
            "state": "WA",
            "postal_code": "99155",
            "telephone_number": "509-422-7735",
            "fax_number": "509-422-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANGELO",
        "first_name": "GLORIA",
        "middle_name": "H",
        "name_prefix": "Mrs.",
        "credential": "PHARM-D",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-05",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00015647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Nespelem, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.