Individual provider Active NPI

Jeffrey Lawrence Vogan, RPH

  • Pharmacist
  • Lynnwood, WA
National Provider Identifier
1629051453
Registry record updated Sep 11, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00011051 Issued in WA
Practice address
13616 Mukilteo Speedway
Suite C
Lynnwood, WA 98087
Phone
(425) 742-1120
Fax
(425) 742-9183
NPI assigned
Nov 25, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 11, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00011051 WA Primary
Pharmacist 183500000X RPH 35915 CA

Addresses

Primary practice location

13616 Mukilteo Speedway
Suite C
Lynnwood, WA 98087

Mailing address

13616 Mukilteo Speedway
Suite C
Lynnwood, WA 98087
Phone (425) 742-1120

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

LicenseStateTypeSpecialty
RPH 35915CAMDPharmacist
PH00011051WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1132876800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1221091200000",
    "number": "1629051453",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13616 MUKILTEO SPEEDWAY",
            "address_2": "SUITE C",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98087",
            "telephone_number": "425-742-1120",
            "fax_number": "425-742-9183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13616 MUKILTEO SPEEDWAY",
            "address_2": "SUITE C",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "98087",
            "telephone_number": "425-742-1120",
            "fax_number": "425-742-9183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VOGAN",
        "first_name": "JEFFREY",
        "middle_name": "LAWRENCE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-25",
        "last_updated": "2008-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00011051",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "RPH 35915",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 11, 2008; 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.