Active NPI
Shannon Tieu
- Pharmacist
- Kirkland, WA
National Provider Identifier
1487308573
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH61187114
- Practice address
- 8629 120TH Ave NE
Kirkland, WA 98033-5822 - Phone
- (425) 822-0414
- Fax
- (425) 822-0811
- NPI assigned
- Feb 8, 2022
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH61187114 | WA | Primary |
Addresses
Primary practice location
8629 120TH Ave NE
Kirkland, WA 98033-5822
Mailing address
8629 120TH Ave NE
Kirkland, WA 98033-5822
Phone (425) 822-0414
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 |
|---|---|---|---|
| PH61187114 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1644278400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1671148800000",
"number": "1487308573",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8629 120TH AVE NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980335822",
"telephone_number": "425-822-0414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8629 120TH AVE NE",
"city": "KIRKLAND",
"state": "WA",
"postal_code": "980335822",
"telephone_number": "425-822-0414",
"fax_number": "425-822-0811"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TIEU",
"first_name": "SHANNON",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-02-08",
"last_updated": "2022-12-16",
"certification_date": "2022-12-16",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH61187114",
"primary": true
}
],
"identifiers": [],
"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 Dec 16, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.