Active NPI
Amy Joy Yanicak, PHARMD, MPH
- Pharmacist
- Lacey, WA
National Provider Identifier
1619424629
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60665592
- Practice address
- 4410 6TH Ave SE
Apt 304
Lacey, WA 98503-1064 - Phone
- (704) 609-6870
- NPI assigned
- Sep 7, 2016
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60665592 | WA | Primary |
Addresses
Primary practice location
4410 6TH Ave SE
Apt 304
Lacey, WA 98503-1064
Mailing address
4410 6TH Ave SE
Apt 304
Lacey, WA 98503-1064
Phone (704) 609-6870
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH60665592 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473206400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473206400000",
"number": "1619424629",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4410 6TH AVE SE",
"address_2": "APT 304",
"city": "LACEY",
"state": "WA",
"postal_code": "985031064",
"telephone_number": "704-609-6870"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4410 6TH AVE SE",
"address_2": "APT 304",
"city": "LACEY",
"state": "WA",
"postal_code": "985031064",
"telephone_number": "704-609-6870"
}
],
"practiceLocations": [],
"basic": {
"last_name": "YANICAK",
"first_name": "AMY",
"middle_name": "JOY",
"credential": "PHARMD, MPH",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2016-09-07",
"last_updated": "2016-09-07",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60665592",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 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.