NPIMap

Individual provider Active NPI

Tore Hagerup, PHARMD

  • Pharmacist
  • Poulsbo, WA
National Provider Identifier
1760782189
Registry record updated Aug 16, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00040135 Issued in WA
Practice address
19245 10TH Ave NE
Poulsbo, WA 98370-7456
Phone
(360) 394-1589
Fax
(360) 394-1758
NPI assigned
Nov 2, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00040135 WA Primary

Addresses

Primary practice location

19245 10TH Ave NE
Poulsbo, WA 98370-7456

Mailing address

19245 10TH Ave NE
Poulsbo, WA 98370-7456
Phone (360) 394-1589

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
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH00040135WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Safeway Inc Past Accepting new patients
Safeway Inc 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.

NPI Registry JSON

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

{
    "created_epoch": "1288656000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1408147200000",
    "number": "1760782189",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19245 10TH AVE NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707456",
            "telephone_number": "360-394-1589",
            "fax_number": "360-394-1758"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19245 10TH AVE NE",
            "city": "POULSBO",
            "state": "WA",
            "postal_code": "983707456",
            "telephone_number": "360-394-1589",
            "fax_number": "360-394-1758"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HAGERUP",
        "first_name": "TORE",
        "name_prefix": "Mr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-11-02",
        "last_updated": "2014-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00040135",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Poulsbo, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 2014; 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.