Individual provider Active NPI

Mary E Hudak, B.PHARM

  • Pharmacist
  • Yakima, WA
National Provider Identifier
1881782415
Registry record updated Jun 9, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00014681 Issued in WA
Practice address
2601 Commerce LN
Yakima, WA 98901-5801
Phone
(509) 374-7113
NPI assigned
Oct 10, 2006
Last updated
Jun 9, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 9, 2021

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X RPH-0014497 OR
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH00014681 WA
Pharmacist 183500000X PH00014681 WA Primary
Pharmacist 183500000X PH60009069 WA

Addresses

Primary practice location

2601 Commerce LN
Yakima, WA 98901-5801

Mailing address

1421 Roza Vista PL
Prosser, WA 99350-1234
Phone (509) 374-7113

Other practice location 1

16351 W. Rio Grande Avenue
Kennewick, WA 99336
Phone (509) 579-4791

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

State licenses

LicenseStateTypeSpecialty
PH00014681WAMDPharmacist
PH60009069WAMDPharmacist
RPH-0014497ORMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623196800000",
    "number": "1881782415",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1421 ROZA VISTA PL",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "993501234",
            "telephone_number": "509-374-7113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2601 COMMERCE LN",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989015801",
            "telephone_number": "509-374-7113"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16351 W. Rio Grande Avenue",
            "address_purpose": "LOCATION",
            "city": "Kennewick",
            "state": "WA",
            "postal_code": "99336",
            "country_code": "US",
            "telephone_number": "509-579-4791",
            "fax_number": "509-579-5907",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUDAK",
        "first_name": "MARY",
        "middle_name": "E",
        "credential": "B.PHARM",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-10",
        "last_updated": "2021-06-09",
        "certification_date": "2021-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "OR",
            "license": "RPH-0014497",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH00014681",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00014681",
            "primary": true
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60009069",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 9, 2021; 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.