Individual provider Active NPI

Andrew Kelly Heinz, PHARMD

  • Pharmacist
  • Puyallup, WA
National Provider Identifier
1376859801
Registry record updated Aug 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60405978 Issued in WA
Practice address
618 S Meridian
Puyallup, WA 98371-5999
Phone
(253) 848-2011
Fax
(253) 848-3119
NPI assigned
Aug 21, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2026

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH60405978 WA
Pharmacist 183500000X PH60405978 WA Primary
Pharmacotherapy Pharmacist 1835P1200X PH60405978 WA
Ambulatory Care Pharmacist 1835P2201X PH60405978 WA

Addresses

Primary practice location

618 S Meridian
Puyallup, WA 98371-5999

Mailing address

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

Other practice location 1

104 Mashell Ave N
Eatonville, WA 98328-8936
Phone (360) 832-3121

Other identifiers 1

IdentifierTypeStateIssuer
2113322MedicaidWA

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
PH60405978WAMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Kirks Pharmacy at Hartland, Inc. CurrentSince Jul 28, 2024 Accepting new patients
Kirks Pharmacy Inc Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist Past Accepting new patients
Kirks Pharmacy at Hartland, Inc. Pharmacist Clinician (PHC)/ Clinical Pharmacy Specialist PastSince Dec 16, 2020 Accepting new patients

Locations

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

Organizations & group practices 3

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": "1282348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1787097600000",
    "number": "1376859801",
    "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": "618 S MERIDIAN",
            "city": "PUYALLUP",
            "state": "WA",
            "postal_code": "983715999",
            "telephone_number": "253-848-2011",
            "fax_number": "253-848-3119"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "104 Mashell Ave N",
            "address_purpose": "LOCATION",
            "city": "Eatonville",
            "state": "WA",
            "postal_code": "983288936",
            "country_code": "US",
            "telephone_number": "360-832-3121",
            "fax_number": "360-832-4520",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HEINZ",
        "first_name": "ANDREW",
        "middle_name": "KELLY",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-08-21",
        "last_updated": "2026-08-19",
        "certification_date": "2026-08-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH60405978",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60405978",
            "primary": true
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WA",
            "license": "PH60405978",
            "primary": false
        },
        {
            "code": "1835P2201X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Ambulatory Care",
            "state": "WA",
            "license": "PH60405978",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2113322",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Puyallup, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 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.