MTM CLINICAL CARE RX (NPI# 1497273528) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497273528 |
| Entity Type | Organization |
| Organization Name | MTM CLINICAL CARE RX |
| Practice Address |
620 Se Everett Mall Way Ste 210b Everett WA 98208-3249 |
| Mailing Address |
20531 76th Ave Se Snohomish WA 98296-5166 |
| Practice Telephone | 2069139664 |
| Mailing Telephone | 2069139664 |
| Enumeration Date | 2017-09-09 |
| Last Update Date | 2018-06-16 |
| Authorized Official Name | JULIE V LE (MTM PHARMACIST) |
| Authorized Official Telephone | 2069139664 |
| Authorized Official Credential | RPH |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 1477966612 | WA | Pharmacy Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 1477966612 | 05 | |
| WA | MEDICARE PART-D | 1477966612 | 01 |
| Street Address |
620 SE EVERETT MALL WAY STE 210B |
| City | EVERETT |
| State | WA |
| Zip Code | 98208-3249 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790270296 | Kenneth Britt Dyer | Registered Nurse | 10333 19th Ave, Se, Ste #109, Everett, WA 98208 | 2018-06-27 |
| 1518482215 | Glacier Peak Healthcare, Inc. | Home Health | 10530 19th Ave Se Ste 201, Everett, WA 98208 | 2017-08-03 |
| 1114454865 | Aliza Kreisman | Registered Nurse | 11020 19th Avenue Se, Kaiser Permanente of Washington Seattle Care Clinic, Everett, WA 98208 | 2017-05-12 |
| 1902269418 | Clay Eakin | Counselor | 2732 Grand Evenue, Everett, WA 98208 | 2016-04-01 |
| 1467810259 | Elizabeth Anne Powley | Marriage & Family Therapist | 1920 100th Street Southeast, Bld C3, Everett, WA 98208 | 2016-02-08 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1396123865 | Sound Surgeons Pllc | Clinic/Center | 125 130th Street Se, 1st Floor, Everett, WA 98208 | 2015-05-15 |
| 1831576537 | Chris Sturgeon | Counselor | 10102 Meridian Ave, Everett, WA 98208 | 2015-05-01 |
| 1982011128 | James M Lee | Physical Therapist | 10821 19th Ave Se Ste 102, Everett, WA 98208 | 2014-07-21 |
| 1972937357 | Ronald Tracy | Dentist | 10315 19th Avenue Se Suite 110, Everett, WA 98208 | 2013-08-21 |
| Find all providers in zip 98208 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982211090 | Paul Vu | Pharmacist | 72 Winslow St, Everett, MA 02149-2112 | 2020-09-23 |
| 1053940031 | Sarah Ann Bottiglio | Pharmacist | Whidden Hospital, 103 Garland Street, Everett, MA 02149 | 2020-04-02 |
| 1609438035 | Samuel Choi | Pharmacist | 4920a Evergreen Way, Everett, WA 98203-2827 | 2019-07-05 |
| 1811457534 | Khushboo Patel | Pharmacist | 1330 Rockefeller Ave Ste 150, Everett, WA 98201 | 2019-03-20 |
| 1356855662 | Jonathan Phong Pham | Pharmacist | 10404 27th Dr Se, Everett, WA 98208-4465 | 2017-11-22 |
| 1497278535 | Michael David Lawrence | Pharmacist | 1800 41st St Ste S-400, Everett, WA 98203-2355 | 2017-07-20 |
| 1962951582 | Abreham Shoangizaw | Pharmacist | 802 134th S B C, Everett, WA 98204 | 2016-09-23 |
| 1396292975 | Aisa Hodzic | Pharmacist | 11 Bellingham Ave, Everett, MA 02149-1218 | 2016-09-01 |
| 1659745842 | Andrea Rose Bedlington | Pharmacist | 11407 33rd Dr. Se, Everett, WA 98208 | 2015-11-25 |
| 1720465123 | Soohyun Kim | Pharmacist | 111 Se Everett Mall Way Ste A100, Everett, WA 98208-3208 | 2015-05-05 |
| Find all providers in EVERETT | ||||
Please comment or provide details below to improve the information on MTM CLINICAL CARE RX.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.