Individual provider Active NPI

Patrick Tra, PHARM.D

  • Pharmacist
  • Kirkland, WA
National Provider Identifier
1659640506
Registry record updated Dec 22, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60169551 Issued in WA
Practice address
12405 NE 85TH St
Kirkland, WA 98033-8032
Phone
(425) 822-9202
NPI assigned
Dec 22, 2011
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 22, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60169551 WA Primary

Addresses

Primary practice location

12405 NE 85TH St
Kirkland, WA 98033-8032

Mailing address

12405 NE 85TH St
Kirkland, WA 98033-8032
Phone (425) 822-9202

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
PH60169551WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1324512000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1324512000000",
    "number": "1659640506",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12405 NE 85TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338032",
            "telephone_number": "425-822-9202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12405 NE 85TH ST",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980338032",
            "telephone_number": "425-822-9202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TRA",
        "first_name": "PATRICK",
        "credential": "PHARM.D",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-12-22",
        "last_updated": "2011-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60169551",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kirkland, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2011; 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.