Roland Koduah

Primary specialty

PharmacistTaxonomy code 183500000X

License

065056 Issued in NY

Practice address

9040 Jackson Avenue
Tacoma, WA 98431-4472

Phone

(253) 968-1941

NPI assigned

Dec 16, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1544918400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721865600000",
    "number": "1679044762",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE #1-71-1A",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984310001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9040 JACKSON AVENUE",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984314472",
            "telephone_number": "253-968-1941"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "537-539 East 138th Street",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "10454",
            "country_code": "US",
            "telephone_number": "718-402-6131",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4301 Wilson St",
            "address_purpose": "LOCATION",
            "city": "Fort Sill",
            "state": "OK",
            "postal_code": "735034472",
            "country_code": "US",
            "telephone_number": "580-558-2443",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KODUAH",
        "first_name": "ROLAND",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-12-16",
        "last_updated": "2024-07-25",
        "certification_date": "2024-07-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "NY",
            "license": "065056",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathon Dustin Kocher, MASSAGE THERAPIST
• Sofya V Kochubey, DENURIST
• Agnes Barbara Kocsis, MD
• Steven Makoto Kodama, MD
• Shaila B Kode, MD
• Margot Alexandra Koehler, CCC-SLP
• Kara Jean Koehn, RN
• Nicholas Philip Koenig, MD
• Rita Koester, MD
• Tamia Mary Kognang

• Pharmacist in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2024; 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.