Active NPI
Michelle Matias
- Pharmacist
- Kent, WA
National Provider Identifier
1376828145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60246743
- Practice address
- 7102 S 220TH St
Kent, WA 98032-1946 - Phone
- (253) 478-4910
- NPI assigned
- Oct 12, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PS48076 | FL | |
| Pharmacist | 183500000X | PH60246743 | WA | Primary |
Addresses
Primary practice location
7102 S 220TH St
Kent, WA 98032-1946
Mailing address
32404 Military Rd S
Unit B
Federal Way, WA 98001-5180
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 |
|---|---|---|---|
| PS48076 | FL | MD | Pharmacist |
| PH60246743 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1318377600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1490054400000",
"number": "1376828145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "32404 MILITARY RD S",
"address_2": "UNIT B",
"city": "FEDERAL WAY",
"state": "WA",
"postal_code": "980015180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7102 S 220TH ST",
"city": "KENT",
"state": "WA",
"postal_code": "980321946",
"telephone_number": "253-478-4910"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MATIAS",
"first_name": "MICHELLE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-10-12",
"last_updated": "2017-03-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "FL",
"license": "PS48076",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60246743",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Kent, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.