Individual provider Active NPI

Yaroslav Khimich, PHARMD

  • Pharmacist
  • Tacoma, WA
National Provider Identifier
1821813122
Registry record updated Nov 21, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH61579103 Issued in WA
Practice address
1850 S Mildred St
Tacoma, WA 98465-1608
Phone
(253) 460-6222
NPI assigned
Nov 21, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 21, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH61579103 WA Primary

Addresses

Primary practice location

1850 S Mildred St
Tacoma, WA 98465-1608

Mailing address

PO Box 1094
Vaughn, WA 98394-1094

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

LicenseStateTypeSpecialty
PH61579103WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1732147200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1732147200000",
    "number": "1821813122",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1094",
            "city": "VAUGHN",
            "state": "WA",
            "postal_code": "983941094"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1850 S MILDRED ST",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984651608",
            "telephone_number": "253-460-6222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KHIMICH",
        "first_name": "YAROSLAV",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-11-21",
        "last_updated": "2024-11-21",
        "certification_date": "2024-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61579103",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Tacoma, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2024; 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.