Kennedy Marie Erickson, PHARMD
Individual provider Active NPI Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist · Chehalis, WA
NPI 1346854585 · NPPES record last updated Sep 25, 2024
Key facts
- NPI
- 1346854585
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X
- License
- PH61448116 (WA)
- Practice address
- 422 S Market Blvd
Chehalis, WA 98532-3044 - Phone
- (360) 262-4211
- NPI assigned
- Sep 4, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH61448116 | WA | MD | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Centralia Pharmacy Group, Inc. | Community/Retail Pharmacy | Current |
Accepting new patients |
| Centralia Pharmacy Group Inc | Current |
Accepting new patients | |
| Tim'S Pharmacy & Gift Shop, LTD | Past |
Accepting new patients | |
| Heddens Pharmacy Inc | Past |
Accepting new patients | |
| Heddens Pharmacy Inc | Community/Retail Pharmacy | Past | Accepting new patients |
| Tim'S Pharmacy & Gift Shop, LTD | Pharmacist | Past |
Accepting new patients |
Locations
417 S Tower Ave
Centralia, WA 98531
Phone (360) 736-5000
422 S Market Blvd
Chehalis, WA 98532
Phone (360) 262-4211
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH61448116 | WA | |
| Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist | 1835P0018X | PH61448116 | WA | Yes |
Addresses
Primary practice location
422 S Market Blvd
Chehalis, WA 98532-3044
Mailing address
210 W Cherry St
Centralia, WA 98531-2568
Phone (360) 561-6773
Other practice location 1
196 Sussex Ave W
Tenino, WA 98589-9327
Phone (360) 264-2575
Other practice location 2
1812 Sumner Ave
Aberdeen, WA 98520-4602
Phone (360) 533-1525
Other practice location 3
417 S Tower Ave
Centralia, WA 98531-3917
Phone (360) 736-5000
Other practice location 4
106 1st St S
Yelm, WA 98597-7700
Phone (360) 458-8467
Other providers in Chehalis, WA
- Eric A Elsemore
- Danae Elsner
- John Richard Elvin
- Sarah Emmett
- Equilibrium Massage & Bodywork
- Ernest M Yamane DDS
- Ernest M. Yamane, DDS PS
- Eugenia Center
- Eugenia Center
- Mary Michelle Evans
All providers in Chehalis, WA · Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 25, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.