NPI Code Detail JSON Logo

1225862162 NPI number — ANNAMAY MOUTAIN HAWK FRY PHARM.D.

NPI Number: 1225862162
Health Care Provider/Practitioner: ANNAMAY MOUTAIN HAWK FRY PHARM.D.

Information about “1225862162” NPI (ANNAMAY MOUTAIN HAWK FRY PHARM.D.) exists in 1225862162 in HTML format HTML  |  1225862162 in plain Text format TXT  |  1225862162 in PDF (Portable Document Format) PDF  |  1225862162 in an XML format XML  formats.

NPI Number : 1225862162 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1225862162",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "Y",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "FRY",
    "FirstName": "ANNAMAY",
    "MiddleName": "MOUTAIN HAWK",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "PHARM.D.",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "2718 KATEENAH WAY APT 24",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "UNION GAP",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98903-1768",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "717-649-7115",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "401 BUSTER RD",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "TOPPENISH",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98948-9792",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "509-865-1703",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "08/30/2024",
    "LastUpdateDate": "08/30/2024",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "183500000X",
        "TaxonomyName": "Pharmacist",
        "LicenseNumber": "PH61564115",
        "LicenseNumberStateCode": "WA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": {
      "HealthcareProviderTaxonomyGroup": {
        "HealthcareProviderTaxonomyGroupName": "193200000X MULTI-SPECIALTY GROUP",
        "HealthcareProviderTaxonomyGroupDescription": "Multi-Specialty Group - A business group of one or more individual practitioners, who practice with different areas of specialization."
      }
    }
  }
}
                
            

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