Active NPI
Gary O Smith, RPH
- Pharmacist
- Monroe, WA
National Provider Identifier
1629014832
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00009189
- Practice address
- 17788 147TH St SE
Monroe, WA 98272-1030 - Phone
- (360) 794-7351
- Fax
- (360) 794-5751
- NPI assigned
- Jun 22, 2006
- Last updated
- Jul 8, 2007
- 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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00009189 | WA | Primary |
Addresses
Primary practice location
17788 147TH St SE
Monroe, WA 98272-1030
Mailing address
PO Box 470
Lake Stevens, WA 98258-0470
Phone (360) 794-7234
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
- Registered Pharmacist
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00009189 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camp Riley Drug Co. Inc | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1150934400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629014832",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 470",
"city": "LAKE STEVENS",
"state": "WA",
"postal_code": "982580470",
"telephone_number": "360-794-7234"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17788 147TH ST SE",
"city": "MONROE",
"state": "WA",
"postal_code": "982721030",
"telephone_number": "360-794-7351",
"fax_number": "360-794-5751"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SMITH",
"first_name": "GARY",
"middle_name": "O",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-06-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00009189",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Monroe, WA
- Sky Valley Chiropractic Clinic P.S.
- Sky Valley Psychedelic Medical
- Sky Valley Wellness, LLC (Sky Valley Wellness)
- Dawn Elizabeth Slack, LMT
- Chrystal Slatter, CERTIFIED PEER COUNS
- Kristin Tomblin Smith, LMP
- Logan Donovon Smith, BS
- Michelle Christina Smith
- Snohomish County Fire District 3
- Snohomish Regional Fire and Rescue
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.