Active NPI
Raymond Bryan Heilman
- Pharmacist
- University Place, WA
National Provider Identifier
1720063373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00010740
- Practice address
- 2700 Bridgeport Way W
Suite D
University Place, WA 98466-4600 - Phone
- (253) 460-1879
- Fax
- (253) 564-1412
- NPI assigned
- Dec 7, 2005
- Sex
- Male
- Sole proprietor
- Yes
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 | PH00010740 | WA | Primary |
Addresses
Primary practice location
2700 Bridgeport Way W
Suite D
University Place, WA 98466-4600
Mailing address
4727 Denver Ave S
Seattle, WA 98134-2316
Phone (206) 763-2626
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00010740 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| The Bartell Drug Co | Past | Accepting new patients | |
| The Bartell Drug Co | 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 and National Provider Directory roles.
-
- Community/Retail Pharmacy
- Tacoma, WA
- NPI 1356423958
-
- Pharmacy
- Seattle, WA
- NPI 1518517101
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1133913600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1212537600000",
"number": "1720063373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4727 DENVER AVE S",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981342316",
"telephone_number": "206-763-2626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2700 BRIDGEPORT WAY W",
"address_2": "SUITE D",
"city": "UNIVERSITY PLACE",
"state": "WA",
"postal_code": "984664600",
"telephone_number": "253-460-1879",
"fax_number": "253-564-1412"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEILMAN",
"first_name": "RAYMOND",
"middle_name": "BRYAN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2005-12-07",
"last_updated": "2008-06-04",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00010740",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in University Place, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.