Individual provider Active NPI

Nguyen Ngo

  • Pharmacist
  • Shoreline, WA
National Provider Identifier
1558735860
Registry record updated Nov 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00058183 Issued in WA
Practice address
17518 15TH Ave NE
Shoreline, WA 98155-3802
Phone
(206) 361-7474
Fax
(206) 361-0220
NPI assigned
Nov 24, 2015
Last updated
Nov 24, 2015By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00058183 WA Primary

Addresses

Primary practice location

17518 15TH Ave NE
Shoreline, WA 98155-3802

Mailing address

17518 15TH Ave NE
Shoreline, WA 98155-3802
Phone (206) 361-7474

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

LicenseStateTypeSpecialty
PH00058183WAMDPharmacist

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1448323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448323200000",
    "number": "1558735860",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17518 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981553802",
            "telephone_number": "206-361-7474",
            "fax_number": "206-361-0220"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17518 15TH AVE NE",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981553802",
            "telephone_number": "206-361-7474",
            "fax_number": "206-361-0220"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NGO",
        "first_name": "NGUYEN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-11-24",
        "last_updated": "2015-11-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00058183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 24, 2015; 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.