Individual provider Active NPI

Tiffany Renee Rabelos, PHARMD

  • Pharmacist
  • Burlington, WA
National Provider Identifier
1477827210
Registry record updated Feb 24, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH 00021777 Issued in WA
Practice address
920 S Burlington Blvd
Burlington, WA 98233-3310
Phone
(360) 757-9133
Fax
(360) 757-9127
NPI assigned
Feb 24, 2012
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 24, 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 PH 00021777 WA Primary

Addresses

Primary practice location

920 S Burlington Blvd
Burlington, WA 98233-3310

Mailing address

920 S Burlington Blvd
Burlington, WA 98233-3310
Phone (360) 757-9133

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH 00021777WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fred Meyer Stores Inc. Past Accepting new patients
Fred Meyer Stores Inc 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": "1330041600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1330041600000",
    "number": "1477827210",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "920 S BURLINGTON BLVD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333310",
            "telephone_number": "360-757-9133",
            "fax_number": "360-757-9127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "920 S BURLINGTON BLVD",
            "city": "BURLINGTON",
            "state": "WA",
            "postal_code": "982333310",
            "telephone_number": "360-757-9133",
            "fax_number": "360-757-9127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RABELOS",
        "first_name": "TIFFANY",
        "middle_name": "RENEE",
        "name_prefix": "Ms.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-02-24",
        "last_updated": "2012-02-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH 00021777",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Burlington, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 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.