John Wallace Kilbourn, RPH

Primary specialty

PharmacistTaxonomy code 183500000X

License

PH00009007 Issued in WA

Practice address

3138 Virginia Way
Longview, WA 98632-5419

Phone

(360) 577-4547

Fax

(360) 575-6608

NPI assigned

May 31, 2008

Last updated

May 31, 2008By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Pharmacist

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Safeway Inc

  dba Safeway Pharmacy #0091

  • Community/Retail Pharmacy
  • Longview, WA
  • NPI 1982640579
  NPD (past)

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

{
    "created_epoch": "1212192000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212192000000",
    "number": "1427216951",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1227 15TH AVE",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323022",
            "telephone_number": "360-575-6605",
            "fax_number": "360-575-6608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3138 VIRGINIA WAY",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986325419",
            "telephone_number": "360-577-4547",
            "fax_number": "360-575-6608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KILBOURN",
        "first_name": "JOHN",
        "middle_name": "WALLACE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-05-31",
        "last_updated": "2008-05-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00009007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gregory G Khurtsidze, M.D.
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• Kidspace Therapy, LLC
• Sheryl A Kiel, LICSW
• Deirdre K Kiest, LMP
• Bria Moira Killgore, MSW, CHES
• Emily Killham
• David Lee Killion, MD
• Choong R Kim, M.D.
• David Sanghyun Kim

• Pharmacist in Longview, WA
• Providers in Longview, WA by specialty
• Pharmacist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 31, 2008; 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.