1861994493 NPI number — I PRESUME PLLC

Table of content: (NPI 1861994493)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861994493 NPI number — I PRESUME PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
I PRESUME PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
SOUND SPECIALTY PHARMACY
Provider Other Organization Name Type Code:
5
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1861994493
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
05/16/2018
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3855 MARTIN WAY E
Provider Second Line Business Mailing Address:
STE A
Provider Business Mailing Address City Name:
OLYMPIA
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98506-5268
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
360-810-3710
Provider Business Mailing Address Fax Number:
360-810-3711

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3855 MARTIN WAY E
Provider Second Line Business Practice Location Address:
STE A
Provider Business Practice Location Address City Name:
OLYMPIA
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98506-5268
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-810-3710
Provider Business Practice Location Address Fax Number:
360-810-3711
Provider Enumeration Date:
02/28/2018

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
LIVINGSTONE
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
Authorized Official Title or Position:
OWNER
Authorized Official Telephone Number:
360-810-3710

Provider Taxonomy Codes

  • Taxonomy code: 333600000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 3336L0003X , with the licence number: 60809217 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 3336S0011X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 2099349 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".
  • Identifier: 2176167 . This is a "PK" identifier . This identifiers is of the category "OTHER".