Chinook Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00058860 Issued in WA

Legal business name

CHINOOK PHARMACY INC

Doing business as

Chinook Pharmacy

Practice address

11 S Forks Ave
Forks, WA 98331-9006

Phone

(360) 374-2294

Fax

(360) 374-5057

NPI assigned

Jul 20, 2006

Last updated

Dec 20, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Shane Harrell, PHARMD

Title

Owner

Phone

(360) 859-8659

Specialties & licenses 1

Addresses

Other identifiers 3

Other names 1

• Chinook Pharmacy Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

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

{
    "created_epoch": "1153353600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766188800000",
    "number": "1063432508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2136",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983312136",
            "telephone_number": "360-374-2294",
            "fax_number": "360-374-5057"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11 S FORKS AVE",
            "city": "FORKS",
            "state": "WA",
            "postal_code": "983319006",
            "telephone_number": "360-374-2294",
            "fax_number": "360-374-5057"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHINOOK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-20",
        "last_updated": "2025-12-20",
        "certification_date": "2025-12-20",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-859-8659",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00058860",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6090203",
            "state": "WA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9045162",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LABOR AND INDUSTRIES",
            "identifier": "16470",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Chinook Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Charles Edward Carlson, RPH
• Amber Telisa Carmody
• Jeffery Lejay Chen, MD
• Chinook Pharmacy Clinical (Chinook Pharmacy INC.)
• Chinook Pharmacy Inc (Chinook Pharmacy LTC)
• Chinook Pharmacy Inc
• Kirk S Christianson, D.C.
• Clallam County Fire Protection District No.1
• Clallam County Public Hospital District #1 (Forks Community Hospital)
• Clallam County Public Hospital District No 1 (Forks Family Medical Clinic)

• Community/Retail Pharmacy in Forks, WA
• Providers in Forks, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.