Individual provider Active NPI

Micah L Reister, PHARMD

  • Pharmacist
  • Wenatchee, WA
National Provider Identifier
1376780965
Registry record updated Jan 19, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH 00064874 Issued in WA
Practice address
933 Red Apple Rd
Suite a
Wenatchee, WA 98801-3370
Phone
(509) 667-3333
NPI assigned
Jan 19, 2009
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH 00064874 WA Primary

Addresses

Primary practice location

933 Red Apple Rd
Suite a
Wenatchee, WA 98801-3370

Mailing address

933 Red Apple Rd
Wenatchee, WA 98801-3370
Phone (509) 667-3333

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
PH 00064874WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1232323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1232323200000",
    "number": "1376780965",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "933 RED APPLE RD",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013370",
            "telephone_number": "509-667-3333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "933 RED APPLE RD",
            "address_2": "SUITE A",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988013370",
            "telephone_number": "509-667-3333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REISTER",
        "first_name": "MICAH",
        "middle_name": "L",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-01-19",
        "last_updated": "2009-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH 00064874",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Wenatchee, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2009; 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.