Active NPI
Martin Lee Dafforn, RPH.
- Pharmacist
- Bellevue, WA
National Provider Identifier
1437366275
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00009893
- Practice address
- 2512 126TH Ave NE
Bellevue, WA 98005-1548 - Phone
- (425) 256-1543
- NPI assigned
- May 17, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00009893 | WA | Primary |
Addresses
Primary practice location
2512 126TH Ave NE
Bellevue, WA 98005-1548
Mailing address
2512 126TH Ave NE
Bellevue, WA 98005-1548
Phone (425) 256-1543
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH00009893 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179360000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1586304000000",
"number": "1437366275",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2512 126TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980051548",
"telephone_number": "425-256-1543"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2512 126TH AVE NE",
"city": "BELLEVUE",
"state": "WA",
"postal_code": "980051548",
"telephone_number": "425-256-1543"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DAFFORN",
"first_name": "MARTIN",
"middle_name": "LEE",
"credential": "RPH.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-17",
"last_updated": "2020-04-08",
"certification_date": "2020-04-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00009893",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bellevue, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.