Active NPI
Carissa Lou Hornick
- Pharmacy Technician
- Kirkland, WA
National Provider Identifier
1467735795
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- VA 00068679
- Practice address
- 6619 132ND Ave NE
Kirkland, WA 98033-8627 - Phone
- (425) 881-5544
- NPI assigned
- Sep 22, 2011
- 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 |
|---|---|---|---|---|
| Pharmacy Technician | 183700000X | VA 00068679 | WA | Primary |
Addresses
Primary practice location
6619 132ND Ave NE
Kirkland, WA 98033-8627
Mailing address
866 4TH Ave NE
Issaquah, WA 98029-5402
Phone (425) 516-4013
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| VA 00068679 | Other | WA | WASHINGTON STATE DEPARTMENT OF HEALTH |
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| VA 00068679 | WA | MD | Pharmacy Technician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1316649600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1316649600000",
"number": "1467735795",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "866 4TH AVE NE",
"city": "ISSAQUAH",
"state": "WA",
"postal_code": "980295402",
"telephone_number": "425-516-4013"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6619 132ND AVE NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980338627",
"telephone_number": "425-881-5544"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HORNICK",
"first_name": "CARISSA",
"middle_name": "LOU",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2011-09-22",
"last_updated": "2011-09-22",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "WA",
"license": "VA 00068679",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE DEPARTMENT OF HEALTH",
"identifier": "VA 00068679",
"state": "WA"
}
],
"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 Sep 22, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.