Individual provider Active NPI

Amphorn Hosakul

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Seattle, WA
National Provider Identifier
1942551221
Registry record updated Sep 26, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PH00017630 Issued in WA
Practice address
1959 NE Pacific St
Box 356015
Seattle, WA 98195
Phone
(206) 598-6060
Fax
(206) 598-6058
NPI assigned
Sep 26, 2012
Last updated
Sep 26, 2012By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 26, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH00017630 WA Primary

Addresses

Primary practice location

1959 NE Pacific St
Box 356015
Seattle, WA 98195

Mailing address

2029A Minor Ave E
Seattle, WA 98102-3513
Phone (206) 598-6058

Other identifiers 1

IdentifierTypeStateIssuer
PH00017630OtherWAWASHIGNTON STATE PHARMACIST LICENSE

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
PH00017630WAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1348617600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348617600000",
    "number": "1942551221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029A MINOR AVE E",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023513",
            "telephone_number": "206-598-6058",
            "fax_number": "206-598-3808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1959 NE PACIFIC ST",
            "address_2": "BOX 356015",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "98195",
            "telephone_number": "206-598-6060",
            "fax_number": "206-598-6058"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOSAKUL",
        "first_name": "AMPHORN",
        "name_prefix": "Mr.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2012-09-26",
        "last_updated": "2012-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH00017630",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WASHIGNTON STATE PHARMACIST LICENSE",
            "identifier": "PH00017630",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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 Sep 26, 2012; 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.