Active NPI
Kaitlynn Johnson, PHARMD
- Pharmacist
- Davenport, WA
National Provider Identifier
1053030452
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH60473503
- Practice address
- 525 Morgan St
Davenport, WA 99122-5213 - Phone
- (509) 725-1151
- Fax
- (509) 725-3028
- NPI assigned
- Aug 26, 2022
- Last updated
- Jun 11, 2025
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH60473503 | WA | Primary |
Addresses
Primary practice location
525 Morgan St
Davenport, WA 99122-5213
Mailing address
692 Lone Pine Rd
Oakesdale, WA 99158-9642
Phone (509) 995-4788
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
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH60473503 | WA | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| 4K Pharms, LLC | Current | Accepting new patients | |
| Tick Klock Drug LLC | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1661472000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1749600000000",
"number": "1053030452",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "692 LONE PINE RD",
"city": "OAKESDALE",
"state": "WA",
"postal_code": "991589642",
"telephone_number": "509-995-4788"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "525 MORGAN ST",
"city": "DAVENPORT",
"state": "WA",
"postal_code": "991225213",
"telephone_number": "509-725-1151",
"fax_number": "509-725-3028"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JOHNSON",
"first_name": "KAITLYNN",
"credential": "PHARMD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2022-08-26",
"last_updated": "2025-06-11",
"certification_date": "2025-06-11",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH60473503",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Davenport, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.