Active NPI
Clinton Brewster
- Pharmacist
- Vancouver, WA
National Provider Identifier
1518214931
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60298525
- Practice address
- 8801 NE Hazel Dell Ave
Vancouver, WA 98665-8145 - Phone
- (360) 713-0005
- NPI assigned
- Aug 6, 2012
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 7452097-1701 | UT | |
| Pharmacist | 183500000X | PH60298525 | WA | Primary |
Addresses
Primary practice location
8801 NE Hazel Dell Ave
Vancouver, WA 98665-8145
Mailing address
8801 NE Hazel Dell Ave
Vancouver, WA 98665-8145
Phone (360) 713-0005
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 |
|---|---|---|---|
| 7452097-1701 | UT | MD | Pharmacist |
| PH60298525 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1344211200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1344211200000",
"number": "1518214931",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8801 NE HAZEL DELL AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986658145",
"telephone_number": "360-713-0005"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8801 NE HAZEL DELL AVE",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986658145",
"telephone_number": "360-713-0005"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BREWSTER",
"first_name": "CLINTON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-08-06",
"last_updated": "2012-08-06",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "7452097-1701",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60298525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 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.