Active NPI
Benjamin Wise, PHARM.D
- Pharmacist
- Clarkston, WA
National Provider Identifier
1811260342
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH 60023724
- Practice address
- 511 3Rd St
Clarkston, WA 99403-1969 - Phone
- (509) 758-8230
- Fax
- (509) 758-8484
- NPI assigned
- Feb 14, 2012
- Sex
- Male
- Sole proprietor
- Yes
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 | PH 60023724 | WA | Primary |
Addresses
Primary practice location
511 3Rd St
Clarkston, WA 99403-1969
Mailing address
511 3Rd St
Clarkston, WA 99403-1969
Phone (509) 758-8230
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH 60023724 | Other | WA | STATE PHARMACIST LICENSE |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH 60023724 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1329177600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1329177600000",
"number": "1811260342",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "511 3RD ST",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994031969",
"telephone_number": "509-758-8230",
"fax_number": "509-758-8484"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "511 3RD ST",
"city": "CLARKSTON",
"state": "WA",
"postal_code": "994031969",
"telephone_number": "509-758-8230",
"fax_number": "509-758-8484"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WISE",
"first_name": "BENJAMIN",
"credential": "PHARM.D",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2012-02-14",
"last_updated": "2012-02-14",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH 60023724",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "STATE PHARMACIST LICENSE",
"identifier": "PH 60023724",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Clarkston, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.