Individual provider Active NPI

Melanie J Reineke, PHARMD

  • Pharmacist
  • Eatonville, WA
National Provider Identifier
1265022305
Registry record updated May 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH61014286 Issued in WA
Practice address
104 Mashell Ave N
Eatonville, WA 98328-8936
Phone
(360) 832-3121
NPI assigned
Jan 22, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 26, 2025

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

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 19543-40 WI
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH61014286 WA
Pharmacotherapy Pharmacist 1835P1200X PH61014286 WA
Ambulatory Care Pharmacist 1835P2201X PH61014286 WA
Phlebotomy Technician 246RP1900X PC61323646 WA
Pharmacist 183500000X PH61014286 WA Primary

Addresses

Primary practice location

104 Mashell Ave N
Eatonville, WA 98328-8936

Mailing address

618 S Meridian
Puyallup, WA 98371-5999
Phone (253) 848-2011

Other identifiers 1

IdentifierTypeStateIssuer
2174263MedicaidWA

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
19543-40WIMDPharmacist
PH61014286WAMDPharmacotherapy Pharmacist
PC61323646WAMDPhlebotomy Technician

Practice roles

OrganizationSpecialtyStatusNew patients
Kirks Pharmacy at Hartland, Inc. CurrentSince Jul 28, 2024 Accepting new patients
Owen-Withee Pharmacy Inc PastSince Jan 1, 2021 Accepting new patients
Kirks Pharmacy Inc Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist PastSince Jun 3, 2025 Accepting new patients
Kirks Pharmacy at Hartland, Inc. Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist PastSince Mar 1, 2021 Accepting new patients

Locations

618 S Meridian
Puyallup, WA 98371
Phone (253) 307-9567

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1611273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1748217600000",
    "number": "1265022305",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "618 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983715999",
            "telephone_number": "253-848-2011",
            "fax_number": "253-848-3119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 MASHELL AVE N",
            "city": "EATONVILLE",
            "state": "WA",
            "postal_code": "983288936",
            "telephone_number": "360-832-3121"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "REINEKE",
        "first_name": "MELANIE",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-01-22",
        "last_updated": "2025-05-26",
        "certification_date": "2025-05-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WI",
            "license": "19543-40",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH61014286",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WA",
            "license": "PH61014286",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WA",
            "license": "PH61014286",
            "primary": false
        },
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "WA",
            "license": "PC61323646",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH61014286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2174263",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Eatonville, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 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.

Verify at the official NPI Registry.