Individual provider Active NPI

Edward Ming Wong, PHARM.D.

  • Pharmacist
  • Centralia, WA
National Provider Identifier
1629445838
Registry record updated Aug 24, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60567666 Issued in WA
Practice address
914 S Scheuber Rd
Centralia, WA 98531-9027
Phone
(360) 827-7985
NPI assigned
Aug 24, 2015
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 24, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60567666 WA Primary

Addresses

Primary practice location

914 S Scheuber Rd
Centralia, WA 98531-9027

Mailing address

413 Lilly Rd NE
Ms: Llh10
Olympia, WA 98506-5133

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

LicenseStateTypeSpecialty
PH60567666WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1440374400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1440374400000",
    "number": "1629445838",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE",
            "address_2": "MS: LLH10",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "914 S SCHEUBER RD",
            "city": "CENTRALIA",
            "state": "WA",
            "postal_code": "985319027",
            "telephone_number": "360-827-7985"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WONG",
        "first_name": "EDWARD",
        "middle_name": "MING",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-08-24",
        "last_updated": "2015-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60567666",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Centralia, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2015; 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.