Active NPI
Marisel Pretorius
- Pharmacist
- Mill Creek, WA
National Provider Identifier
1508120890
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH 00051567
- Practice address
- 3322 132ND St SE
Mill Creek, WA 98012-5654 - Phone
- (425) 338-1891
- Fax
- (425) 338-2863
- NPI assigned
- Jul 1, 2012
- 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 | PH 00051567 | WA | Primary |
Addresses
Primary practice location
3322 132ND St SE
Mill Creek, WA 98012-5654
Mailing address
3322 132ND St SE
Mill Creek, WA 98012-5654
Phone (425) 338-1891
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 |
|---|---|---|---|
| PH 00051567 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1341100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1341100800000",
"number": "1508120890",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3322 132ND ST SE",
"city": "MILL CREEK",
"state": "WA",
"postal_code": "980125654",
"telephone_number": "425-338-1891",
"fax_number": "425-338-2863"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3322 132ND ST SE",
"city": "MILL CREEK",
"state": "WA",
"postal_code": "980125654",
"telephone_number": "425-338-1891",
"fax_number": "425-338-2863"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PRETORIUS",
"first_name": "MARISEL",
"name_prefix": "Mrs.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-07-01",
"last_updated": "2012-07-01",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH 00051567",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Mill Creek, WA
- Kenneth C Plitt, RN, ARNP, CRNA
- PNC Podiatry of Washington PLLC
- Polzin Chiropractic Inc PS (Innovative Chiropractic)
- Kristina Porter, LMP
- Beverly Nicole Prater, MA60862028
- Jennifer Anna Phan Prewitt, DPT
- Matthew G Price, MD
- Primelife PLLC
- Proliance Surgeons, Inc., P.S. (Proliance Physical & Hand Therapy)
- Proliance Surgeons, Inc., P.S. (Proliance Physical & Hand Therapy)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 1, 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.