Individual provider Active NPI

Kylie Klenoski, PHARMD

  • Pharmacist
  • Lynden, WA
National Provider Identifier
1215353107
Registry record updated Mar 15, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH00065481 Issued in WA
Practice address
8090 Guide Meridian Rd
Lynden, WA 98264-9210
Phone
(360) 354-4284
NPI assigned
Mar 15, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 15, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH00065481 WA Primary

Addresses

Primary practice location

8090 Guide Meridian Rd
Lynden, WA 98264-9210

Mailing address

8090 Guide Meridian Rd
Lynden, WA 98264-9210
Phone (360) 354-4284

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
PH00065481WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1394841600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394841600000",
    "number": "1215353107",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8090 GUIDE MERIDIAN RD",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982649210",
            "telephone_number": "360-354-4284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8090 GUIDE MERIDIAN RD",
            "city": "LYNDEN",
            "state": "WA",
            "postal_code": "982649210",
            "telephone_number": "360-354-4284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLENOSKI",
        "first_name": "KYLIE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-03-15",
        "last_updated": "2014-03-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00065481",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynden, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 15, 2014; 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.