Individual provider Active NPI

Erica Leigh Fallis, RPH

  • Pharmacist
  • Tacoma, WA
National Provider Identifier
1366576076
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00014391 Issued in WA
Practice address
1901 S Union Ave
Tacoma, WA 98405-1702
Phone
(253) 453-6200
Fax
(253) 588-3658
NPI assigned
Mar 15, 2007
Sex
Female
Sole proprietor
Yes

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 PH00014391 WA Primary

Addresses

Primary practice location

1901 S Union Ave
Tacoma, WA 98405-1702

Mailing address

PO Box 7804
Bonney Lake, WA 98391-0977
Phone (253) 863-1004

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

LicenseStateTypeSpecialty
PH00014391WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1173916800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1366576076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7804",
            "city": "BONNEY LAKE",
            "state": "WA",
            "postal_code": "983910977",
            "telephone_number": "253-863-1004",
            "fax_number": "253-588-3658"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1901 S UNION AVE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984051702",
            "telephone_number": "253-453-6200",
            "fax_number": "253-588-3658"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FALLIS",
        "first_name": "ERICA",
        "middle_name": "LEIGH",
        "name_prefix": "Miss",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00014391",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, 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.