Amanda Diane Brookhaus

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH61068927 Issued in WA

Practice address

1322 3Rd St SE
Puyallup, WA 98372-3771

Phone

(303) 548-5795

NPI assigned

Apr 15, 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

State licenses

Interoperability endpoints

• Direct secure messaging: abrookhaus1764354@ghc.direct-ci.net

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

{
    "created_epoch": "1618444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1633305600000",
    "number": "1770164352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17838 75TH AVE E",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983753304",
            "telephone_number": "303-548-5795"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1322 3RD ST SE",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983723771",
            "telephone_number": "303-548-5795"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROOKHAUS",
        "first_name": "AMANDA",
        "middle_name": "DIANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-15",
        "last_updated": "2021-10-04",
        "certification_date": "2021-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61068927",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Grace Broeker
• Marianne Theodora Broers, MD
• Christine Therese Broniak, DO
• Michael Perry Brook, M.D.
• Brookdale Senior Living Communities, Inc.
• Brooksby & Associates PLLC
• Robin J. Brooksby Jr., PH.D. LP
• Broughton Dunn PLLC
• Broughton Dunn PLLC
• Steven Scott Broughton, DDS PS

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2021; 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.