Active NPI
Travis Wall
- Pharmacist
- Spokane, WA
National Provider Identifier
1326518960
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60874850
- Practice address
- 933 E Mission Ave
Spokane, WA 99202 - Phone
- (509) 482-2089
- NPI assigned
- Nov 27, 2018
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60874850 | WA | Primary |
Addresses
Primary practice location
933 E Mission Ave
Spokane, WA 99202
Mailing address
8808 N. Indian Trail Rd. #5103
Spokane, WA 99208
Phone (801) 631-4177
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 |
|---|---|---|---|
| PH60874850 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Community/Retail Pharmacy
- Spokane, WA
- NPI 1902835911
-
- Community/Retail Pharmacy
- Queen Creek, AZ
- NPI 1730040973
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1543276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1543276800000",
"number": "1326518960",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8808 N. INDIAN TRAIL RD. #5103",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99208",
"telephone_number": "801-631-4177"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "933 E MISSION AVE",
"city": "SPOKANE",
"state": "WA",
"postal_code": "99202",
"telephone_number": "509-482-2089"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "TRAVIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-11-27",
"last_updated": "2018-11-27",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60874850",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.