Active NPI
Joseph T Bong, PHARM.D.
- Pharmacist
- Lynnwood, WA
National Provider Identifier
1528465770
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60405537
- Practice address
- 17414 Highway 99
Suite 100
Lynnwood, WA 98037-3112 - Phone
- (425) 741-0075
- Fax
- (425) 741-0083
- NPI assigned
- Dec 2, 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 | PH60405537 | WA | Primary |
Addresses
Primary practice location
17414 Highway 99
Suite 100
Lynnwood, WA 98037-3112
Mailing address
17414 Highway 99
Suite 100
Lynnwood, WA 98037-3112
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
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60405537 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Bethel Pharmacy Inc | Past | Accepting new patients |
Organizations & group practices 1
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": "1417478400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1417478400000",
"number": "1528465770",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17414 HIGHWAY 99",
"address_2": "SUITE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980373112"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17414 HIGHWAY 99",
"address_2": "SUITE 100",
"city": "LYNNWOOD",
"state": "WA",
"postal_code": "980373112",
"telephone_number": "425-741-0075",
"fax_number": "425-741-0083"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BONG",
"first_name": "JOSEPH",
"middle_name": "T",
"credential": "PHARM.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2014-12-02",
"last_updated": "2014-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60405537",
"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 Dec 2, 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.