Active NPI
Craig H Tavis, RPH
- Pharmacist
- Shelton, WA
National Provider Identifier
1730489675
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00018023
- Practice address
- 901 Mountain View Dr
Shelton, WA 98584-4401 - Phone
- (360) 426-2500
- Fax
- (360) 426-2787
- NPI assigned
- Oct 26, 2010
- Sex
- Male
- 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 | PH00018023 | WA | Primary |
Addresses
Primary practice location
901 Mountain View Dr
Shelton, WA 98584-4401
Mailing address
PO Box 244
Oakville, WA 98568-0244
Phone (360) 701-1537
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 |
|---|---|---|---|
| PH00018023 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1288051200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1658361600000",
"number": "1730489675",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 244",
"city": "OAKVILLE",
"state": "WA",
"postal_code": "985680244",
"telephone_number": "360-701-1537",
"fax_number": "360-330-0896"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 MOUNTAIN VIEW DR",
"city": "SHELTON",
"state": "WA",
"postal_code": "985844401",
"telephone_number": "360-426-2500",
"fax_number": "360-426-2787"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TAVIS",
"first_name": "CRAIG",
"middle_name": "H",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2010-10-26",
"last_updated": "2022-07-21",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00018023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Shelton, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 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.