Individual provider Active NPI

Leann Y Dittmar, PHARMD

  • Pharmacist
  • Seattle, WA
National Provider Identifier
1912296187
Registry record updated Mar 28, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00061826 Issued in WA
Practice address
1001 Broadway Ste 102
Seattle, WA 98122-4342
Phone
(206) 324-2335
NPI assigned
Mar 28, 2011
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 28, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00061826 WA Primary

Addresses

Primary practice location

1001 Broadway Ste 102
Seattle, WA 98122-4342

Mailing address

11362 28TH Ave NE
Seattle, WA 98125-6727
Phone (206) 240-1097

Other names 1

  • Leann Kim Other name

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

LicenseStateTypeSpecialty
PH00061826WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1301270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301270400000",
    "number": "1912296187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11362 28TH AVE NE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981256727",
            "telephone_number": "206-240-1097",
            "fax_number": "206-324-2274"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 BROADWAY STE 102",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981224342",
            "telephone_number": "206-324-2335"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DITTMAR",
        "first_name": "LEANN",
        "middle_name": "Y",
        "name_prefix": "Mrs.",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-28",
        "last_updated": "2011-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00061826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "LEANN",
            "last_name": "KIM",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2011; 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.