Individual provider Active NPI

Forouzan Danesh

  • Pharmacist
  • Mukilteo, WA
National Provider Identifier
1477823367
Registry record updated Jan 9, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00043370 Issued in WA
Practice address
10200 Mukilteo Speedway
Mukilteo, WA 98275-4743
Phone
(425) 315-9213
Fax
(425) 315-9553
NPI assigned
Jan 9, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 9, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00043370 WA Primary

Addresses

Primary practice location

10200 Mukilteo Speedway
Mukilteo, WA 98275-4743

Mailing address

10200 Mukilteo Speedway
Mukilteo, WA 98275-4743
Phone (425) 315-9213

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

LicenseStateTypeSpecialty
PH00043370WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1326067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1326067200000",
    "number": "1477823367",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10200 MUKILTEO SPEEDWAY",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982754743",
            "telephone_number": "425-315-9213",
            "fax_number": "425-315-9553"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10200 MUKILTEO SPEEDWAY",
            "city": "MUKILTEO",
            "state": "WA",
            "postal_code": "982754743",
            "telephone_number": "425-315-9213",
            "fax_number": "425-315-9553"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DANESH",
        "first_name": "FOROUZAN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-01-09",
        "last_updated": "2012-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00043370",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mukilteo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2012; 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.