Grachelle Gonong

Primary specialty

PharmacistTaxonomy code 183500000X

License

61351039 Issued in WA

Practice address

7411 NE 117TH Ave
Vancouver, WA 98662-4706

Phone

(360) 896-3533

NPI assigned

Nov 25, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Fred Meyer Stores Inc

  • Community/Retail Pharmacy
  • Vancouver, WA
  • NPI 1437194826
  NPD (past)
• Fred Meyer Stores Inc.

  • Community/Retail Pharmacy
  • Lynnwood, WA
  • NPI 1558235762
  NPD (past)

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

{
    "created_epoch": "1669334400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670544000000",
    "number": "1346950839",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3800 SE 22ND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972022918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7411 NE 117TH AVE",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986624706",
            "telephone_number": "360-896-3533"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3800 SE 22nd Ave",
            "address_purpose": "LOCATION",
            "city": "Portland",
            "state": "OR",
            "postal_code": "972022918",
            "country_code": "US",
            "telephone_number": "503-797-3825",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GONONG",
        "first_name": "GRACHELLE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-25",
        "last_updated": "2022-12-09",
        "certification_date": "2022-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "0019298",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "61351039",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sumona Marie Gomes
• Victor Gomes, ARNP, PMHNP-BC
• Katherin Gomez-Arboleda
• Virginia Gomez
• Anastasiia May Goncharenko, SUDP
• Elizabeth Gonzales Lim, RN
• Angelo Alexander Gonzales
• Emily Gonzales, LMT
• Ethan D Gonzales, RECOVERY COACH
• Isabella Moriah Gonzales

• Pharmacist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 9, 2022; 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.