Individual provider Active NPI

Gardenia Jazmin Contreras Vazquez, PHARMD

  • Pharmacist
  • Sunnyside, WA
National Provider Identifier
1548879539
Registry record updated Sep 14, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61445867 Issued in WA
Practice address
1016 Tacoma Ave
Sunnyside, WA 98944-2263
Phone
(509) 837-1500
NPI assigned
Jul 27, 2020
Last updated
Sep 14, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 14, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61445867 WA Primary

Addresses

Primary practice location

1016 Tacoma Ave
Sunnyside, WA 98944-2263

Mailing address

1525 S 13TH St
Sunnyside, WA 98944-2490

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

LicenseStateTypeSpecialty
61445867WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1595808000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694649600000",
    "number": "1548879539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1525 S 13TH ST",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442490"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1016 TACOMA AVE",
            "city": "SUNNYSIDE",
            "state": "WA",
            "postal_code": "989442263",
            "telephone_number": "509-837-1500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CONTRERAS VAZQUEZ",
        "first_name": "GARDENIA",
        "middle_name": "JAZMIN",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-27",
        "last_updated": "2023-09-14",
        "certification_date": "2023-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "61445867",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sunnyside, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2023; 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.