Active NPI
Mary Dordi Hartshorn, RPH
- Pharmacist
- Everett, WA
National Provider Identifier
1861767501
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00015065
- Practice address
- 10200 19TH Ave SE
Everett, WA 98208-4256 - Phone
- (425) 379-7487
- NPI assigned
- Mar 13, 2012
- Sex
- Female
- Sole proprietor
- No
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 | PH00015065 | WA | Primary |
Addresses
Primary practice location
10200 19TH Ave SE
Everett, WA 98208-4256
Mailing address
13907 55TH Dr SE
Everett, WA 98208-9449
Phone (425) 379-7487
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
| License | State | Type | Specialty |
|---|---|---|---|
| PH00015065 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1331596800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1331596800000",
"number": "1861767501",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13907 55TH DR SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982089449",
"telephone_number": "425-379-7487"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "10200 19TH AVE SE",
"city": "EVERETT",
"state": "WA",
"postal_code": "982084256",
"telephone_number": "425-379-7487"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARTSHORN",
"first_name": "MARY",
"middle_name": "DORDI",
"credential": "RPH",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-03-13",
"last_updated": "2012-03-13",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00015065",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 13, 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.