Individual provider Active NPI

Abreham Shoangizaw

  • Pharmacist
  • Everett, WA
National Provider Identifier
1962951582
Registry record updated Sep 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00016413 Issued in WA
Practice address
802 134TH S B C
Everett, WA 98204
Phone
(800) 607-6861
NPI assigned
Sep 23, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00016413 WA Primary

Addresses

Primary practice location

802 134TH S B C
Everett, WA 98204

Mailing address

5020 Chinook Dr
Everett, WA 98203-1300
Phone (425) 350-5051

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
PH00016413WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1474588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474588800000",
    "number": "1962951582",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5020 CHINOOK DR",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "982031300",
            "telephone_number": "425-350-5051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "802 134TH S B C",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98204",
            "telephone_number": "800-607-6861"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOANGIZAW",
        "first_name": "ABREHAM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-09-23",
        "last_updated": "2016-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00016413",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Everett, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2016; 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.