Individual provider Active NPI

Jennifer Sylvia Arnold, PHARM.D.

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Renton, WA
National Provider Identifier
1093875247
Registry record updated Sep 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacist Clinician (PhC)/ Clinical Pharmacy SpecialistTaxonomy code 1835P0018X
License
PH00064847 Issued in WA
Practice address
411 Williams Ave S
Renton, WA 98057-2748
Phone
(425) 207-3642
Fax
(425) 277-3897
NPI assigned
Dec 11, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00064847 WA
Pharmacotherapy Pharmacist 1835P1200X PH00064847 WA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH00064847 WA Primary

Addresses

Primary practice location

411 Williams Ave S
Renton, WA 98057-2748

Mailing address

411 Williams Ave S
Renton, WA 98057-2748
Phone (425) 207-3642

Other identifiers 1

IdentifierTypeStateIssuer
PH00064847OtherWALISENSING NUMBER

Other names 1

  • Dr. Jennifer Sylvia Riddell Former name

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

LicenseStateTypeSpecialty
PH00064847WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1165795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725408000000",
    "number": "1093875247",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "411 WILLIAMS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572748",
            "telephone_number": "425-207-3642",
            "fax_number": "425-277-3897"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "411 WILLIAMS AVE S",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980572748",
            "telephone_number": "425-207-3642",
            "fax_number": "425-277-3897"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARNOLD",
        "first_name": "JENNIFER",
        "middle_name": "SYLVIA",
        "name_prefix": "Dr.",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-11",
        "last_updated": "2024-09-04",
        "certification_date": "2024-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00064847",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WA",
            "license": "PH00064847",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH00064847",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISENSING NUMBER",
            "identifier": "PH00064847",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JENNIFER",
            "last_name": "RIDDELL",
            "middle_name": "SYLVIA",
            "prefix": "DR.",
            "credential": "PHARM.D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.