Charmaine Jade Lacanilao, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH61565093 Issued in WA

Practice address

3901 Hoyt Ave
Everett, WA 98201-4918

Phone

(425) 317-3619

NPI assigned

Jan 2, 2021

Sex

Female

Sole proprietor

No

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

Credentials

Doctor of Pharmacy

State licenses

Practice roles

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.

• Optum Care Washington PLLC

  • Ambulatory Surgical Clinic/Center
  • Everett, WA
  • NPI 1154318103
  NPD (past)
• The Polyclinic PLLC

  dba Optum Care Washington

  • Durable Medical Equipment & Medical Supplies
  • Seattle, WA
  • NPI 1346620200
  NPD (past)

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

{
    "created_epoch": "1609545600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1679161087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5415 135TH PL SW",
            "city": "EDMONDS",
            "state": "WA",
            "postal_code": "980263337",
            "telephone_number": "425-563-8677"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3901 HOYT AVE",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982014918",
            "telephone_number": "425-317-3619"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LACANILAO",
        "first_name": "CHARMAINE",
        "middle_name": "JADE",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-02",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61565093",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abigail Laberge, RBT
• Salwa R Labib, MD
• Laboratory Corporation of America
• Laboratory Corporation of America
• Laboratory Corporation of America
• Shyla Carissa Lacasse, MA, AAC
• Shawnda Lachmund-Blake
• Raymond Francis Lacko Jr.
• Kendra Lacoste
• Breezy Lafever

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.