Active NPI
Tyler Jason Varnum
- Pharmacist
- Selah, WA
National Provider Identifier
1427028265
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- PH00051639
- Practice address
- 609 Speyers Rd
Selah, WA 98942-1050 - Phone
- (509) 698-1244
- Fax
- (509) 697-2217
- NPI assigned
- Jan 24, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | PH00051639 | WA | Primary |
Addresses
Primary practice location
609 Speyers Rd
Selah, WA 98942-1050
Mailing address
552 Imperial Dr
Hanford, CA 93230-7316
Other practice location 1
2636 Fairview Rd
Ellensburg, WA 98926-7106
Phone (509) 494-9711
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PH00051639 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1138060800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1646784000000",
"number": "1427028265",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "552 IMPERIAL DR",
"city": "HANFORD",
"state": "CA",
"postal_code": "932307316"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "609 SPEYERS RD",
"city": "SELAH",
"state": "WA",
"postal_code": "989421050",
"telephone_number": "509-698-1244",
"fax_number": "509-697-2217"
}
],
"practiceLocations": [
{
"address_1": "2636 Fairview Rd",
"address_purpose": "LOCATION",
"city": "Ellensburg",
"state": "WA",
"postal_code": "989267106",
"country_code": "US",
"telephone_number": "509-494-9711",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "VARNUM",
"first_name": "TYLER",
"middle_name": "JASON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-24",
"last_updated": "2022-03-09",
"certification_date": "2022-03-09",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "PH00051639",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Selah, WA
- James Tuttle
- Valley Behavioral Health (Valley Behavioral Services)
- Amanda Valsonis, LPN
- Braden Vandyke, DMD
- Brianna Vargas
- Christina Jean Vickers
- Warninger Chiropractic Clinic - Selah Office
- Kay Warnock
- Washington State Dept. of Social & Health Services (Yakima Valley School Pharmacy)
- Richard P. Washut, D.D.S.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.