Abdul Khaleel Qayoum, PHARMD.

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH00067111 Issued in WA

Practice address

413 Lilly Rd NE # LL-H10
Olympia, WA 98506-5133

Phone

(360) 493-7412

Fax

(360) 493-5403

NPI assigned

Jun 25, 2011

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Credena Health LLC

  • Community/Retail Pharmacy
  • Seattle, WA
  • NPI 1982342226
  NPD (past)
• Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Pullman, WA
  • NPI 1659480960
  NPD (past)
• Thrifty Payless Inc

  • Community/Retail Pharmacy
  • Winchester, CA
  • NPI 1437874062
  NPD (past)

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

{
    "created_epoch": "1308960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1597017600000",
    "number": "1962798157",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE # LL-H10",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-7412",
            "fax_number": "360-493-5403"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "413 LILLY RD NE # LL-H10",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065133",
            "telephone_number": "360-493-7412",
            "fax_number": "360-493-5403"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "QAYOUM",
        "first_name": "ABDUL",
        "middle_name": "KHALEEL",
        "credential": "PHARMD.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-06-25",
        "last_updated": "2020-08-10",
        "certification_date": "2020-08-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00067111",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tom A Putaansuu, M.ED.
• Ladonna Putman, MS, LMHC, SUDP
• Tammy Lynn Hupp Putvin, MA
• Walter Theodore Putvin, ATC
• Pwyc Healthcare, PLLC
• Yang Qu, PA
• Kate Quackenbush
• Rebecca Maree Quade
• Ranee Naa Bigi Quaye, MD
• Sarah Quenemoen

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

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 10, 2020; 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.