Active NPI
Hans W Fredericksen, RPH
- Pharmacotherapy Pharmacist
- Ephrata, WA
National Provider Identifier
1336449941
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacotherapy Pharmacist
- License
- PH000016364
- Practice address
- 1150 Basin St SW
Ephrata, WA 98823-2138 - Phone
- (509) 754-3567
- Fax
- (509) 754-3837
- NPI assigned
- Oct 28, 2010
- Last updated
- Oct 28, 2010
- 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 |
|---|---|---|---|---|
| Pharmacotherapy Pharmacist | 1835P1200X | PH000016364 | WA | Primary |
Addresses
Primary practice location
1150 Basin St SW
Ephrata, WA 98823-2138
Mailing address
1150 Basin St SW
Ephrata, WA 98823-2138
Phone (509) 754-3567
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH000016364 | WA | MD | Pharmacotherapy 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288224000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1288224000000",
"number": "1336449941",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1150 BASIN ST SW",
"city": "EPHRATA",
"state": "WA",
"postal_code": "988232138",
"telephone_number": "509-754-3567",
"fax_number": "509-754-3837"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1150 BASIN ST SW",
"city": "EPHRATA",
"state": "WA",
"postal_code": "988232138",
"telephone_number": "509-754-3567",
"fax_number": "509-754-3837"
}
],
"practiceLocations": [],
"basic": {
"last_name": "FREDERICKSEN",
"first_name": "HANS",
"middle_name": "W",
"name_prefix": "Mr.",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-28",
"last_updated": "2010-10-28",
"status": "A"
},
"taxonomies": [
{
"code": "1835P1200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pharmacotherapy",
"state": "WA",
"license": "PH000016364",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ephrata, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.