Ken Luong Pham

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH60844394 Issued in WA

Practice address

412 E College Way
Mount Vernon, WA 98273-5516

Phone

(360) 424-7958

NPI assigned

May 25, 2021

Last updated

Jul 15, 2021By the provider in NPPES

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

Practice roles

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.

• Thrifty Payless Inc

  dba Rite Aid Pharmacy 05237

  • Community/Retail Pharmacy
  • Bellingham, WA
  • NPI 1083621924
  NPD (past)
• Thrifty Payless Inc

  dba Rite Aid Pharmacy 05239

  • Community/Retail Pharmacy
  • Bellingham, WA
  • NPI 1285743591
  NPD (past)
• Thrifty Payless Inc

  dba Rite Aid Pharmacy 06503

  • Community/Retail Pharmacy
  • Marysville, WA
  • NPI 1285876904
  NPD (past)
• Thrifty Payless Inc

  dba Rite Aid Pharmacy 05236

  • Community/Retail Pharmacy
  • Bellingham, WA
  • NPI 1689785818
  NPD (past)
• Thrifty Payless Inc

  dba Rite Aid Pharmacy 05245

  • Community/Retail Pharmacy
  • Mount Vernon, WA
  • NPI 1881703106
  NPD (past)
• Thrifty Payless Inc

  dba Rite Aid Pharmacy 05240

  • Community/Retail Pharmacy
  • Bellingham, WA
  • NPI 1881705028
  NPD (past)
• Thrifty Payless Inc

  dba Rite Aid Pharmacy 06833

  • Community/Retail Pharmacy
  • Winchester, CA
  • NPI 1437874062
  NPD (past)

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

{
    "created_epoch": "1621900800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626307200000",
    "number": "1609441351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "516 N 1ST ST",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982732811",
            "telephone_number": "972-762-4115"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "412 E COLLEGE WAY",
            "city": "MOUNT VERNON",
            "state": "WA",
            "postal_code": "982735516",
            "telephone_number": "360-424-7958"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8090 Guide Meridian Rd",
            "address_purpose": "LOCATION",
            "city": "Lynden",
            "state": "WA",
            "postal_code": "982649210",
            "country_code": "US",
            "telephone_number": "360-354-4284",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 Cornwall Ave",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982254520",
            "country_code": "US",
            "telephone_number": "360-733-1980",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "205 Pine Ave",
            "address_purpose": "LOCATION",
            "city": "Snohomish",
            "state": "WA",
            "postal_code": "982902539",
            "country_code": "US",
            "telephone_number": "360-563-0223",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "17226 Smokey Point Blvd",
            "address_purpose": "LOCATION",
            "city": "Arlington",
            "state": "WA",
            "postal_code": "982238718",
            "country_code": "US",
            "telephone_number": "360-657-4410",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3733 116th St NE",
            "address_purpose": "LOCATION",
            "city": "Marysville",
            "state": "WA",
            "postal_code": "982718423",
            "country_code": "US",
            "telephone_number": "360-653-5178",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 E Sunset Dr Ste 110",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982263590",
            "country_code": "US",
            "telephone_number": "360-671-5041",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "222 Telegraph Rd",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982268080",
            "country_code": "US",
            "telephone_number": "360-676-8570",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "516 N 1st St",
            "address_purpose": "LOCATION",
            "city": "Mount Vernon",
            "state": "WA",
            "postal_code": "982732811",
            "country_code": "US",
            "telephone_number": "972-762-4115",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3227 Northwest Ave",
            "address_purpose": "LOCATION",
            "city": "Bellingham",
            "state": "WA",
            "postal_code": "982251317",
            "country_code": "US",
            "telephone_number": "360-647-2175",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PHAM",
        "first_name": "KEN",
        "middle_name": "LUONG",
        "name_prefix": "Dr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-05-25",
        "last_updated": "2021-07-15",
        "certification_date": "2021-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "62183",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60844394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Linda E Pettit, BA, CLN II
• Felicia M Petty, REGISTERED COUNSELOR
• Joan Pfeiffer, RD
• Henning Pforte, MD
• Daniel Pham, MD
• Phoenix Recovery House
• Phoenix Recovery Services, LLC
• Phoenix Recovery Services, LLC
• Michael J. Picco, DO
• Gretchen Pickett

• Pharmacist in Mount Vernon, WA
• Providers in Mount Vernon, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2021; 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.