Active NPI
Halli Broder Waldbaum, PHARM.D.
- Pharmacist
- Redmond, WA
National Provider Identifier
1871665281
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00041078
- Practice address
- 8862 161St Ave NE
Redmond, WA 98052-7553 - Phone
- (425) 883-4882
- NPI assigned
- Nov 14, 2006
- Sex
- Female
- 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 | PH00041078 | WA | Primary |
Addresses
Primary practice location
8862 161St Ave NE
Redmond, WA 98052-7553
Mailing address
24002 SE 12TH PL
Sammamish, WA 98075-8151
Phone (425) 394-0139
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 |
|---|---|---|---|
| PH00041078 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163462400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1871665281",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24002 SE 12TH PL",
"city": "SAMMAMISH",
"state": "WA",
"postal_code": "980758151",
"telephone_number": "425-394-0139"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8862 161ST AVE NE",
"city": "REDMOND",
"state": "WA",
"postal_code": "980527553",
"telephone_number": "425-883-4882"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALDBAUM",
"first_name": "HALLI",
"middle_name": "BRODER",
"name_prefix": "Mrs.",
"credential": "PHARM.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-14",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00041078",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Redmond, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.