Castle Rock Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR.CF.00001975 Issued in WA

Legal business name

CASTLE ROCK PHARMACY INC

Practice address

117 1St SW
Castle Rock, WA 98611

Phone

(360) 274-8211

Fax

(360) 274-7825

NPI assigned

Aug 10, 2006

Organization subpart

No

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

Authorized official

Name

Jonathon Rodeback

Title

Owner

Phone

(360) 274-8211

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• CASTLE ROCK PHARMACY Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Marvin James Waletich, RPH

  • Pharmacist
  • Castle Rock, WA
  • NPI 1376289116
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776816000000",
    "number": "1306857800",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 188",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "986110188",
            "telephone_number": "360-274-8211",
            "fax_number": "360-274-7825"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "117 1ST SW",
            "city": "CASTLE ROCK",
            "state": "WA",
            "postal_code": "98611",
            "telephone_number": "360-274-8211",
            "fax_number": "360-274-7825"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CASTLE ROCK PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2026-04-22",
        "certification_date": "2026-04-22",
        "status": "A",
        "authorized_official_last_name": "RODEBACK",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-274-8211"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.00001975",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106573",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6166805",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CASTLE ROCK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "CASTLE ROCK PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Reinhild Elisabeth Ayoub, MD
• Sally Bern
• Philip William Blair, MD
• Dallas Ray Carroll, CDP
• Castle Rock Pediatrics and Family Wellness Center
• Castle Rock School District #401
• Summer Noel Catlin, M.S.CCC-SLP
• Sandra Jo Chavez, RN
• City of Castle Rock
• Melinda Conn

• Community/Retail Pharmacy in Castle Rock, WA
• Providers in Castle Rock, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2026; 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.