Active NPI
Nicole Diana Conde, PHARMD
- Pediatric Pharmacist
- Tacoma, WA
National Provider Identifier
1417653387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pediatric Pharmacist
- License
- PH61180372
- Practice address
- 317 Martin Luther King Jr Way
Tacoma, WA 98405-4234 - Phone
- (253) 403-3755
- NPI assigned
- Feb 2, 2023
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Pharmacist | 1835P0200X | PH61180372 | WA | Primary |
Addresses
Primary practice location
317 Martin Luther King Jr Way
Tacoma, WA 98405-4234
Mailing address
6563 McDonald Ave Unit 302
Gig Harbor, WA 98335-2110
Phone (509) 280-7412
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH61180372 | WA | MD | Pediatric Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1675296000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675296000000",
"number": "1417653387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "6563 MCDONALD AVE UNIT 302",
"city": "GIG HARBOR",
"state": "WA",
"postal_code": "983352110",
"telephone_number": "509-280-7412"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "317 MARTIN LUTHER KING JR WAY",
"city": "TACOMA",
"state": "WA",
"postal_code": "984054234",
"telephone_number": "253-403-3755"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONDE",
"first_name": "NICOLE",
"middle_name": "DIANA",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-02-02",
"last_updated": "2023-02-02",
"certification_date": "2023-02-02",
"status": "A"
},
"taxonomies": [
{
"code": "1835P0200X",
"taxonomy_group": "",
"desc": "Pharmacist, Pediatrics",
"state": "WA",
"license": "PH61180372",
"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 Feb 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.