Trang Le Gagne-Fongemie, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH 00021571 Issued in WA

Practice address

11311 Bridgeport Way
Suite 300
Lakewood, WA 98499

Phone

(253) 985-6790

Fax

(253) 985-6705

NPI assigned

Apr 8, 2010

Last updated

Apr 8, 2010By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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

• Franciscan Health System

  dba St Clare Anticoagulation Clinic

  • Registered Nurse
  • Lakewood, WA
  • NPI 1285905992
  NPD (past)

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

{
    "created_epoch": "1270684800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1270684800000",
    "number": "1467778910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11311 BRIDGEPORT WAY SW",
            "address_2": "SUITE 300",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984993071",
            "telephone_number": "253-985-6790",
            "fax_number": "253-985-6705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11311 BRIDGEPORT WAY",
            "address_2": "SUITE 300",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "98499",
            "telephone_number": "253-985-6790",
            "fax_number": "253-985-6705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GAGNE-FONGEMIE",
        "first_name": "TRANG",
        "middle_name": "LE",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-04-08",
        "last_updated": "2010-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH 00021571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE",
            "identifier": "PH 00021571",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Coleman Frostad, BA
• Elizha-Grace Fontanilla Fulgencio
• Caleb Andrew Gabriel, RBT/CBT
• Zachary Gabriychuk
• Tracy Gage, BA
• Kristin E Gaines
• Galbreath Consulting
• Holly Noel Galbreath, PHD
• Taylor Mackenzie Galbreath
• Deepa Gali, MD

• Pharmacist in Lakewood, WA
• Providers in Lakewood, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2010; 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.