Individual provider Active NPI

Preetham Reddy Kaliki

  • Pharmacist
  • Lakewood, WA
National Provider Identifier
1962734749
Registry record updated Feb 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
69709 Issued in WA
Practice address
9505 Bridgeport Way SW
Lakewood, WA 98499-2801
Phone
(125) 358-2223
Fax
(125) 358-2065
NPI assigned
Feb 4, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 69709 WA Primary

Addresses

Primary practice location

9505 Bridgeport Way SW
Lakewood, WA 98499-2801

Mailing address

9505 Bridgeport Way SW
Lakewood, WA 98499-2801
Phone (125) 358-2223

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
69709WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1265241600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1265241600000",
    "number": "1962734749",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9505 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992801",
            "telephone_number": "125-358-2223",
            "fax_number": "125-358-2065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9505 BRIDGEPORT WAY SW",
            "city": "LAKEWOOD",
            "state": "WA",
            "postal_code": "984992801",
            "telephone_number": "125-358-2223",
            "fax_number": "125-358-2065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALIKI",
        "first_name": "PREETHAM",
        "middle_name": "REDDY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-02-04",
        "last_updated": "2010-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "69709",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lakewood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 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.

Verify at the official NPI Registry.