Individual provider Active NPI

Parisima Kheradmand, RPH

  • Pharmacist
  • Issaquah, WA
National Provider Identifier
1497934723
Registry record updated Nov 2, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH21053 Issued in WA
Practice address
5530 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-6804
Phone
(425) 391-7867
Fax
(425) 391-8425
NPI assigned
Nov 2, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 2, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH21053 WA Primary

Addresses

Primary practice location

5530 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-6804

Mailing address

5530 E Lake Sammamish Pkwy SE
Issaquah, WA 98029-6804
Phone (425) 391-7867

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

LicenseStateTypeSpecialty
PH21053WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1193961600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193961600000",
    "number": "1497934723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5530 E LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296804",
            "telephone_number": "425-391-7867",
            "fax_number": "425-391-8425"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 E LAKE SAMMAMISH PKWY SE",
            "city": "ISSAQUAH",
            "state": "WA",
            "postal_code": "980296804",
            "telephone_number": "425-391-7867",
            "fax_number": "425-391-8425"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHERADMAND",
        "first_name": "PARISIMA",
        "name_prefix": "Ms.",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-11-02",
        "last_updated": "2007-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH21053",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Issaquah, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2007; 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.