Active NPI
John Joseph Dougherty, PHARMD
- Compounded Sterile Preparations Pharmacist
- Everett, WA
National Provider Identifier
1619657145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Compounded Sterile Preparations Pharmacist
- License
- PH60317262
- Practice address
- 1717 13TH St Ste 300
Everett, WA 98201-1621 - Phone
- (425) 297-5500
- NPI assigned
- Jul 19, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Compounded Sterile Preparations Pharmacist | 1835C0207X | PH60317262 | WA | Primary |
Addresses
Primary practice location
1717 13TH St Ste 300
Everett, WA 98201-1621
Mailing address
3522 222ND PL SE
Bothell, WA 98021-4223
Phone (206) 816-5337
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 |
|---|---|---|---|
| PH60317262 | WA | MD | Medical license number |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1689724800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1689724800000",
"number": "1619657145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3522 222ND PL SE",
"city": "BOTHELL",
"state": "WA",
"postal_code": "980214223",
"telephone_number": "206-816-5337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1717 13TH ST STE 300",
"city": "EVERETT",
"state": "WA",
"postal_code": "982011621",
"telephone_number": "425-297-5500"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DOUGHERTY",
"first_name": "JOHN",
"middle_name": "JOSEPH",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2023-07-19",
"last_updated": "2023-07-19",
"certification_date": "2023-07-19",
"status": "A"
},
"taxonomies": [
{
"code": "1835C0207X",
"taxonomy_group": "",
"desc": "Pharmacist, Compounded Sterile Preparations",
"state": "WA",
"license": "PH60317262",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.