Individual provider Active NPI

Cynthia K Mackenzie, RPH

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Kirkland, WA
National Provider Identifier
1467727198
Registry record updated Mar 13, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PH 60526855 Issued in WA
Practice address
12333 NE 130TH LN
Tan 415
Kirkland, WA 98034-7467
Phone
(425) 899-2783
NPI assigned
Mar 13, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 13, 2015

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X 008291 OR
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH 60526855 WA Primary

Addresses

Primary practice location

12333 NE 130TH LN
Tan 415
Kirkland, WA 98034-7467

Mailing address

12333 NE 130TH LN
Tan 415
Kirkland, WA 98034-7467
Phone (425) 899-2783

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
008291ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
PH 60526855WAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

Practice roles

OrganizationSpecialtyStatusNew patients
King County Public Hospital District No 2 Past Accepting new patients
Evergreenhealthcare Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1331596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426204800000",
    "number": "1467727198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12333 NE 130TH LN",
            "address_2": "TAN 415",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347467",
            "telephone_number": "425-899-2783"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12333 NE 130TH LN",
            "address_2": "TAN 415",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980347467",
            "telephone_number": "425-899-2783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MACKENZIE",
        "first_name": "CYNTHIA",
        "middle_name": "K",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-13",
        "last_updated": "2015-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "008291",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH 60526855",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 2015; 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.