Individual provider Active NPI

David Au, RPH.

  • Pharmacist
  • Kent, WA
National Provider Identifier
1790151363
Registry record updated Aug 18, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60483489 Issued in WA
Practice address
25250 Pacific Hwy S
Kent, WA 98032-6539
Phone
(253) 946-7433
NPI assigned
Aug 18, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 18, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60483489 WA Primary

Addresses

Primary practice location

25250 Pacific Hwy S
Kent, WA 98032-6539

Mailing address

20723 121St Way SE
Kent, WA 98031-4190
Phone (206) 619-1940

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
PH60483489WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Fred Meyer Stores Inc. Past Accepting new patients
Fred Meyer Stores 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": "1439856000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1439856000000",
    "number": "1790151363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20723 121ST WAY SE",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980314190",
            "telephone_number": "206-619-1940"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25250 PACIFIC HWY S",
            "city": "KENT",
            "state": "WA",
            "postal_code": "980326539",
            "telephone_number": "253-946-7433"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AU",
        "first_name": "DAVID",
        "credential": "RPH.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-08-18",
        "last_updated": "2015-08-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60483489",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kent, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 18, 2015; 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.