Individual provider Active NPI

Alex Kaushansky, PHARMACIST

  • Pharmacist
  • Shoreline, WA
National Provider Identifier
1811227747
Registry record updated Dec 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00055269 Issued in WA
Practice address
17524 Aurora Ave N
Shoreline, WA 98133-4813
Phone
(206) 542-4964
NPI assigned
Dec 24, 2009
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 24, 2009

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00055269 WA Primary
Pharmacist 183500000X 1863 AK

Addresses

Primary practice location

17524 Aurora Ave N
Shoreline, WA 98133-4813

Mailing address

19212 1St Ave W
Bothell, WA 98012-6268
Phone (425) 774-5867

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

LicenseStateTypeSpecialty
1863AKMDPharmacist
PH00055269WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1261612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1261612800000",
    "number": "1811227747",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19212 1ST AVE W",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980126268",
            "telephone_number": "425-774-5867"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17524 AURORA AVE N",
            "city": "SHORELINE",
            "state": "WA",
            "postal_code": "981334813",
            "telephone_number": "206-542-4964"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAUSHANSKY",
        "first_name": "ALEX",
        "name_prefix": "Dr.",
        "credential": "PHARMACIST",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-12-24",
        "last_updated": "2009-12-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00055269",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AK",
            "license": "1863",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shoreline, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 24, 2009; 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.