Individual provider Active NPI

Hunter Bud Weitze, RPH

  • Pharmacist
  • Colfax, WA
National Provider Identifier
1710607239
Registry record updated Sep 2, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH61307179 Issued in WA
Practice address
109 S Main St
Colfax, WA 99111-1803
Phone
(509) 397-2111
NPI assigned
Sep 2, 2022
Last updated
Sep 2, 2022By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 2, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH61307179 WA Primary

Addresses

Primary practice location

109 S Main St
Colfax, WA 99111-1803

Mailing address

202 N Mill St Apt 8
Colfax, WA 99111-1856
Phone (509) 288-1595

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

LicenseStateTypeSpecialty
PH61307179WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Tick Klock Drug LLC CurrentSince Sep 4, 2022 Accepting new patients

Locations

109 S Main St
Colfax, WA 99111
Phone (509) 397-2111

Organizations & group practices 1

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": "1662076800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662076800000",
    "number": "1710607239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "202 N MILL ST APT 8",
            "city": "COLFAX",
            "state": "WA",
            "postal_code": "991111856",
            "telephone_number": "509-288-1595"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 S MAIN ST",
            "city": "COLFAX",
            "state": "WA",
            "postal_code": "991111803",
            "telephone_number": "509-397-2111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WEITZE",
        "first_name": "HUNTER",
        "middle_name": "BUD",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-02",
        "last_updated": "2022-09-02",
        "certification_date": "2022-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61307179",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colfax, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2022; 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.