Individual provider Active NPI

Todd James Kean

  • Pharmacist
  • Yakima, WA
National Provider Identifier
1215345848
Registry record updated Jul 16, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60080677 Issued in WA
Practice address
3708 Tieton Dr
Yakima, WA 98902
Phone
(509) 966-6850
Fax
(509) 966-2690
NPI assigned
Jul 28, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 16, 2019

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60080677 WA Primary

Addresses

Primary practice location

3708 Tieton Dr
Yakima, WA 98902

Mailing address

3708 Tieton Dr
Yakima, WA 98902-3664
Phone (509) 966-6850

Other practice location 1

6600 W Nob Hill Blvd
Yakima, WA 98908-1976
Phone (509) 966-3814

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

State licenses

LicenseStateTypeSpecialty
PH60080677WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1406505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1563235200000",
    "number": "1215345848",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3708 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023664",
            "telephone_number": "509-966-6850",
            "fax_number": "509-966-2690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3708 TIETON DR",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-966-6850",
            "fax_number": "509-966-2690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6600 W Nob Hill Blvd",
            "address_purpose": "LOCATION",
            "city": "Yakima",
            "state": "WA",
            "postal_code": "989081976",
            "country_code": "US",
            "telephone_number": "509-966-3814",
            "fax_number": "509-966-3876",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KEAN",
        "first_name": "TODD",
        "middle_name": "JAMES",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-07-28",
        "last_updated": "2019-07-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60080677",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Yakima, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2019; 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.