Individual provider Active NPI

Peter Shoukrala, BPHARM

  • Pharmacist
  • Bothell, WA
National Provider Identifier
1992329841
Registry record updated Jun 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60975314 Issued in WA
Practice address
20812 Bothell Everett Hwy
Bothell, WA 98021-8404
Phone
(425) 398-0204
NPI assigned
Jun 5, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60975314 WA Primary

Addresses

Primary practice location

20812 Bothell Everett Hwy
Bothell, WA 98021-8404

Mailing address

21511 4TH Ave W Unit A62
Bothell, WA 98021-7573
Phone (425) 215-6756

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
PH60975314WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1591315200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1591315200000",
    "number": "1992329841",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21511 4TH AVE W UNIT A62",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980217573",
            "telephone_number": "425-215-6756"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20812 BOTHELL EVERETT HWY",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218404",
            "telephone_number": "425-398-0204"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOUKRALA",
        "first_name": "PETER",
        "credential": "BPHARM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-05",
        "last_updated": "2020-06-05",
        "certification_date": "2020-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60975314",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bothell, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 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.