Keith Mark Herner, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH00016997 Issued in WA

Practice address

1201 39TH Ave SW
Puyallup, WA 98373-3803

Phone

(253) 445-7542

Fax

(253) 445-7549

NPI assigned

Oct 17, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Interoperability endpoints

• Direct secure messaging: w660phm@costco.com

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

{
    "created_epoch": "1571270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571270400000",
    "number": "1922641364",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 39TH AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733803",
            "telephone_number": "253-445-7542",
            "fax_number": "253-445-7549"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 39TH AVE SW",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983733803",
            "telephone_number": "253-445-7542",
            "fax_number": "253-445-7549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERNER",
        "first_name": "KEITH",
        "middle_name": "MARK",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-10-17",
        "last_updated": "2019-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00016997",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "W660phm@costco.com",
            "affiliation": "N",
            "address_1": "1201 39th Ave SW",
            "city": "Puyallup",
            "state": "WA",
            "country_code": "US",
            "postal_code": "983733803",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• David Ellis Hensley, CPO, FAAOP
• Leah Jacqueline Herman, MPH, PA-S
• Cynthia Carol Hernan
• Alicia Hernandez, ARNP
• Dorothy Michelle Hernandez
• Glenn Herrera
• Oscar Herrera
• Kathleen Herron, LMP
• Lindsay Herron
• Stuart G Hersey, D.D.S., M.S.D.

• Pharmacist in Puyallup, WA
• Providers in Puyallup, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2019; 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.