Active NPI
Mary E Hudak, B.PHARM
- Pharmacist
- Yakima, WA
National Provider Identifier
1881782415
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00014681
- Practice address
- 2601 Commerce LN
Yakima, WA 98901-5801 - Phone
- (509) 374-7113
- NPI assigned
- Oct 10, 2006
- Last updated
- Jun 9, 2021
- 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 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| PH00014681 | WA | MD | Pharmacist |
| PH60009069 | WA | MD | Pharmacist |
| RPH-0014497 | OR | MD | Pharmacist 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.