Active NPI
Phillip Michael Anciaux, PHARMD
- Pharmacist
- Redmond, WA
National Provider Identifier
1811441850
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH 60626956
- Practice address
- 3925 236TH Ave NE
Redmond, WA 98053-8455 - Phone
- (425) 836-9173
- Fax
- (425) 836-8728
- NPI assigned
- Aug 8, 2016
- Last updated
- Jan 23, 2017
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH 60626956 | WA | Primary |
| Pharmacist | 183500000X | 22253 | IA | |
| Pharmacist | 183500000X | 122151 | MN |
Addresses
Primary practice location
3925 236TH Ave NE
Redmond, WA 98053-8455
Mailing address
3925 236TH Ave NE
Redmond, WA 98053-8455
Phone (425) 836-9173
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 |
|---|---|---|---|
| 22253 | IA | MD | Pharmacist |
| 122151 | MN | MD | Pharmacist |
| PH 60626956 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1470614400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1485129600000",
"number": "1811441850",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3925 236TH AVE NE",
"city": "REDMOND",
"state": "WA",
"postal_code": "980538455",
"telephone_number": "425-836-9173",
"fax_number": "425-836-8728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3925 236TH AVE NE",
"city": "REDMOND",
"state": "WA",
"postal_code": "980538455",
"telephone_number": "425-836-9173",
"fax_number": "425-836-8728"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ANCIAUX",
"first_name": "PHILLIP",
"middle_name": "MICHAEL",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2016-08-08",
"last_updated": "2017-01-23",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH 60626956",
"primary": true
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "IA",
"license": "22253",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "MN",
"license": "122151",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, WA
- Amba Speech and Language Center, LLC
- American Current Care of Washington, P.S. (Concentra Urgent Care)
- Ramtin Amini, M.D.,D.M.D
- Michael Edward Amos, O.D.
- Catherine W Amundson, ARNP
- Carolyn M Anderson
- Maxine Kehaunani Lorita Anderson, LICSW
- Tana Anderson, MA, LMHC
- Valeria Del Valle Anderson, MS, LMHCA
- Virginia Anderson, MHC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.