Kevin Kha Ly

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH61311531 Issued in WA

Practice address

5700 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-8914

Phone

(808) 232-7841

NPI assigned

Oct 12, 2022

Last updated

Oct 12, 2022By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1665532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665532800000",
    "number": "1386369395",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1300 EAGLE RIDGE DR S APT K1071",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980553412",
            "telephone_number": "808-232-7841"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5700 E LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980298914",
            "telephone_number": "808-232-7841"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LY",
        "first_name": "KEVIN",
        "middle_name": "KHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-10-12",
        "last_updated": "2022-10-12",
        "certification_date": "2022-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61311531",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michelle Lutz, DPT, OCS
• Luxottica of America Inc. (Pearle Vision #6551)
• Yu Lwo, DDS
• Amy B Ly, ARNP
• Andrew Ly
• Stephen J Lynch, D.C.
• Elizabeth Ann Lynner, BC-HIS
• James J Ma
• Francesca Macauley, LPN
• Priya Ruth Macdonald, O.D.

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.