Active NPI
Jessica Marie Otero, PHARMD
- Pharmacist
- Seattle, WA
National Provider Identifier
1962721746
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00069947
- Practice address
- 4800 Sand Point Way NE
M/S R-3409
Seattle, WA 98105-3901 - Phone
- (206) 987-6262
- Fax
- (206) 987-6337
- NPI assigned
- May 19, 2010
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PHA-16103 | CO | |
| Pharmacist | 183500000X | PH00069947 | WA | Primary |
Addresses
Primary practice location
4800 Sand Point Way NE
M/S R-3409
Seattle, WA 98105-3901
Mailing address
M/S R-3409 PO Box 5371
Seattle, WA 98105
Phone (206) 987-6262
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| PH00069947 | Other | WA | WASHINGTON STATE PHARMACIST LICENSE |
| PHA-16103 | Other | CO | COLORDADO STATE PHARMACIST |
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
| License | State | Type | Specialty |
|---|---|---|---|
| PHA-16103 | CO | MD | Pharmacist |
| PH00069947 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1274227200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1274227200000",
"number": "1962721746",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "M/S R-3409 PO BOX 5371",
"city": "SEATTLE",
"state": "WA",
"postal_code": "98105",
"telephone_number": "206-987-6262",
"fax_number": "206-987-6337"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4800 SAND POINT WAY NE",
"address_2": "M/S R-3409",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981053901",
"telephone_number": "206-987-6262",
"fax_number": "206-987-6337"
}
],
"practiceLocations": [],
"basic": {
"last_name": "OTERO",
"first_name": "JESSICA",
"middle_name": "MARIE",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-19",
"last_updated": "2010-05-19",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "CO",
"license": "PHA-16103",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00069947",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE PHARMACIST LICENSE",
"identifier": "PH00069947",
"state": "WA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "COLORDADO STATE PHARMACIST",
"identifier": "PHA-16103",
"state": "CO"
}
],
"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 May 19, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.