Luke Aaron Vander Weide, PHARM.D.

Primary specialty

Ambulatory Care PharmacistTaxonomy code 1835P2201X

License

PH60561814 Issued in WA

Practice address

16811 SE McGillivray Blvd
#101
Vancouver, WA 98683-3404

Phone

(360) 750-3206

NPI assigned

Apr 1, 2015

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

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

{
    "created_epoch": "1427846400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1478044800000",
    "number": "1568857134",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16811 SE MCGILLIVRAY BLVD",
            "address_2": "#101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833404",
            "telephone_number": "360-750-3206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16811 SE MCGILLIVRAY BLVD",
            "address_2": "#101",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986833404",
            "telephone_number": "360-750-3206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VANDER WEIDE",
        "first_name": "LUKE",
        "middle_name": "AARON",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-04-01",
        "last_updated": "2016-11-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OH",
            "license": "03234108",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WA",
            "license": "PH60561814",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Vancouver Wellness Clinic, LLC
• Vancouver Wellness Studio, PLLC
• Helene E Vandeberg, CP RC
• Nichole Dianne Vandel, SUDPT
• Isabelle Rose Vanden Branden, MS
• Shelley Vanderheyden, RPH
• Mia Jean Vandermeer, SUDPT
• Jessica Leigh Vandermerwe
• Laura E Vanderstarre, RD
• Leayn N Vandeven, NP-C

• Ambulatory Care Pharmacist in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Ambulatory Care Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2016; 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.