NPIMap

Individual provider Active NPI

Gary James Lee, R.PH.

  • Pharmacist
  • Walla Walla, WA
National Provider Identifier
1831429448
Registry record updated Jan 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60126989 Issued in WA
Practice address
1651 W Rose St
Walla Walla, WA 99362-1689
Phone
(509) 525-9207
NPI assigned
Jan 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60126989 WA Primary

Addresses

Primary practice location

1651 W Rose St
Walla Walla, WA 99362-1689

Mailing address

1651 W Rose St
Walla Walla, WA 99362-1689
Phone (509) 525-9207

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
PH60126989WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Shopko Stores Operating Co. LLC Past Accepting new patients
Shopko Stores Operating Co LLC 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": "1262563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1262563200000",
    "number": "1831429448",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1651 W ROSE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621689",
            "telephone_number": "509-525-9207"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1651 W ROSE ST",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993621689",
            "telephone_number": "509-525-9207"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEE",
        "first_name": "GARY",
        "middle_name": "JAMES",
        "credential": "R.PH.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-01-04",
        "last_updated": "2010-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60126989",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Walla Walla, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2010; 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.