Active NPI
Connie Sue Skavdahl, RPH
- Pharmacist
- Richland, WA
National Provider Identifier
1659711380
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00010074
- Practice address
- 101 Wellsian Way
Richland, WA 99352-4150 - Phone
- (509) 943-8358
- Fax
- (509) 943-3236
- NPI assigned
- Jun 26, 2013
- Last updated
- Jun 26, 2013
- Sex
- Female
- 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 | PH00010074 | WA | Primary |
Addresses
Primary practice location
101 Wellsian Way
Richland, WA 99352-4150
Mailing address
101 Wellsian Way
Richland, WA 99352-4150
Phone (509) 943-8358
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 |
|---|---|---|---|
| PH00010074 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fred Meyer Stores Inc | Past | Accepting new patients | |
| Fred Meyer Stores Inc. | Past | Accepting new patients |
Organizations & group practices 2
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": "1372204800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1372204800000",
"number": "1659711380",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 WELLSIAN WAY",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524150",
"telephone_number": "509-943-8358",
"fax_number": "509-943-3236"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "101 WELLSIAN WAY",
"city": "RICHLAND",
"state": "WA",
"postal_code": "993524150",
"telephone_number": "509-943-8358",
"fax_number": "509-943-3236"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKAVDAHL",
"first_name": "CONNIE",
"middle_name": "SUE",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-06-26",
"last_updated": "2013-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00010074",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richland, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.