Individual provider Active NPI

Brenda Kelly, PHARM.D.

  • Pharmacist
  • Yakima, WA
National Provider Identifier
1265621759
Registry record updated Oct 19, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
68688 Issued in WA
Practice address
2811 Tieton Dr
Department of Pharmacy
Yakima, WA 98902-3761
Phone
(509) 575-8823
Fax
(509) 575-8700
NPI assigned
Oct 19, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 68688 WA Primary

Addresses

Primary practice location

2811 Tieton Dr
Department of Pharmacy
Yakima, WA 98902-3761

Mailing address

2811 Tieton Dr
Department of Pharmacy
Yakima, WA 98902-3761
Phone (509) 575-8823

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
68688WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1192752000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1192752000000",
    "number": "1265621759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "address_2": "DEPARTMENT OF PHARMACY",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023761",
            "telephone_number": "509-575-8823",
            "fax_number": "509-575-8700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2811 TIETON DR",
            "address_2": "DEPARTMENT OF PHARMACY",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989023761",
            "telephone_number": "509-575-8823",
            "fax_number": "509-575-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLY",
        "first_name": "BRENDA",
        "credential": "PHARM.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-10-19",
        "last_updated": "2007-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "68688",
            "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 Oct 19, 2007; 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.