Active NPI
Seifu A Eshetu, RPH
- Pharmacist
- Lynnwood, WA
National Provider Identifier
1497164420
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00042724
- Practice address
- 17222 Highway 99
Lynnwood, WA 98037-3170 - Phone
- (425) 245-1713
- Fax
- (425) 245-1713
- NPI assigned
- Aug 4, 2014
- Sex
- Male
- 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 | PH00042724 | WA | Primary |
Addresses
Primary practice location
17222 Highway 99
Lynnwood, WA 98037-3170
Mailing address
17222 Highway 99
Lynnwood, WA 98037-3170
Phone (425) 245-1713
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00042724 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart 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": "1407110400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1407110400000",
"number": "1497164420",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17222 HIGHWAY 99",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980373170",
"telephone_number": "425-245-1713",
"fax_number": "425-245-1713"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17222 HIGHWAY 99",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980373170",
"telephone_number": "425-245-1713",
"fax_number": "425-245-1713"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESHETU",
"first_name": "SEIFU",
"middle_name": "A",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-08-04",
"last_updated": "2014-08-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00042724",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lynnwood, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.