Active NPI
Mary Connolly
- Pharmacist
- Lacey, WA
National Provider Identifier
1932581840
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH 60323754
- Practice address
- 5110 Yelm Hwy SE
Lacey, WA 98503-5060 - Phone
- (360) 252-2907
- NPI assigned
- Jun 26, 2015
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH 60323754 | WA | Primary |
Addresses
Primary practice location
5110 Yelm Hwy SE
Lacey, WA 98503-5060
Mailing address
5110 Yelm Hwy SE
Lacey, WA 98503-5060
Phone (360) 252-2907
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 |
|---|---|---|---|
| PH 60323754 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walmart Inc. | Past | Accepting new patients | |
| Walmart Inc. | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1435276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1435276800000",
"number": "1932581840",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5110 YELM HWY SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985035060",
"telephone_number": "360-252-2907"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5110 YELM HWY SE",
"city": "LACEY",
"state": "WA",
"postal_code": "985035060",
"telephone_number": "360-252-2907"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CONNOLLY",
"first_name": "MARY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-06-26",
"last_updated": "2015-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH 60323754",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lacey, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.