Onileola Mayowa Ilesanmi

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60042077 Issued in WA

Practice address

1200 Harrison Ave
Centralia, WA 98531-1853

Phone

(360) 807-2014

NPI assigned

Apr 27, 2011

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

State licenses

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

{
    "created_epoch": "1303862400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1303862400000",
    "number": "1578854311",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2916A RUSSELL RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311724",
            "telephone_number": "360-977-3773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 HARRISON AVE",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985311853",
            "telephone_number": "360-807-2014"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ILESANMI",
        "first_name": "ONILEOLA",
        "middle_name": "MAYOWA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-04-27",
        "last_updated": "2011-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60042077",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0012095",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jordan A Hunter
• Tina Huynh-Pham, PHARMD
• Dang Huynh, RPH
• Karen Marie Hyatt, COTA
• Stevi Denise Hyde
• Laura Ing
• Deborah Ingram
• April Inman, LMHCA
• Innovations in Eyecare Inc.
• Alexzander Isenhower

• Pharmacist in Centralia, WA
• Providers in Centralia, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2011; 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.