Individual provider Active NPI

Saradha Vedula, RPH

  • Pharmacist
  • Woodinville, WA
National Provider Identifier
1457755233
Registry record updated Oct 22, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00059324 Issued in WA
Practice address
17641 Garden Way NE
Woodinville, WA 98072-3535
Phone
(425) 398-6710
Fax
(425) 398-6728
NPI assigned
Oct 22, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00059324 WA Primary

Addresses

Primary practice location

17641 Garden Way NE
Woodinville, WA 98072-3535

Mailing address

17641 Garden Way NE
Woodinville, WA 98072-3535
Phone (425) 398-6710

Other identifiers 1

IdentifierTypeStateIssuer
PH00059324OtherWAPHARMACIST

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

LicenseStateTypeSpecialty
PH00059324WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1413936000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1413936000000",
    "number": "1457755233",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17641 GARDEN WAY NE",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980723535",
            "telephone_number": "425-398-6710",
            "fax_number": "425-398-6728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17641 GARDEN WAY NE",
            "city": "WOODINVILLE",
            "state": "WA",
            "postal_code": "980723535",
            "telephone_number": "425-398-6710",
            "fax_number": "425-398-6728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VEDULA",
        "first_name": "SARADHA",
        "name_prefix": "Mrs.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-10-22",
        "last_updated": "2014-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00059324",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST",
            "identifier": "PH00059324",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodinville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2014; 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.