Active NPI
Crystal Nettekoven
- Pharmacy Technician
- Auburn, WA
National Provider Identifier
1487042909
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy Technician
- License
- VA60397416
- Practice address
- 3902 A St SE
Auburn, WA 98002-8610 - Phone
- (253) 939-8563
- NPI assigned
- Jan 6, 2015
- Last updated
- Jan 6, 2015
- Sex
- Female
- Sole proprietor
- Yes
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 | VA60397416 | WA | Primary |
Addresses
Primary practice location
3902 A St SE
Auburn, WA 98002-8610
Mailing address
3030 M St SE Apt 25
Auburn, WA 98002-8055
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 |
|---|---|---|---|
| VA60397416 | WA | MD | Pharmacy Technician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Bartell Drug Co | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1420502400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1420502400000",
"number": "1487042909",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3030 M ST SE APT 25",
"city": "AUBURN",
"state": "WA",
"postal_code": "980028055"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3902 A ST SE",
"city": "AUBURN",
"state": "WA",
"postal_code": "980028610",
"telephone_number": "253-939-8563"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NETTEKOVEN",
"first_name": "CRYSTAL",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2015-01-06",
"last_updated": "2015-01-06",
"status": "A"
},
"taxonomies": [
{
"code": "183700000X",
"taxonomy_group": "",
"desc": "Pharmacy Technician",
"state": "WA",
"license": "VA60397416",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.