Individual provider Active NPI

Ryan Glenn Pett, PHARM.D., MPH

  • Pharmacotherapy Pharmacist
  • Toppenish, WA
National Provider Identifier
1497193296
Registry record updated Oct 10, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pharmacotherapy PharmacistTaxonomy code 1835P1200X
License
PH60632918 Issued in WA
Practice address
401 Buster Rd
Toppenish, WA 98948-9792
Phone
(509) 865-1703
Fax
(509) 865-8753
NPI assigned
Jun 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 10, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X S019784 AZ
Pharmacotherapy Pharmacist 1835P1200X PH60632918 WA Primary

Addresses

Primary practice location

401 Buster Rd
Toppenish, WA 98948-9792

Mailing address

401 Buster Rd
Toppenish, WA 98948-9792
Phone (509) 865-1703

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
S019784AZMDPharmacist
PH60632918WAMDPharmacotherapy Pharmacist

NPI Registry JSON

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

{
    "created_epoch": "1371081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570665600000",
    "number": "1497193296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 BUSTER RD",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989489792",
            "telephone_number": "509-865-1703",
            "fax_number": "509-865-8753"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 BUSTER RD",
            "city": "TOPPENISH",
            "state": "WA",
            "postal_code": "989489792",
            "telephone_number": "509-865-1703",
            "fax_number": "509-865-8753"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PETT",
        "first_name": "RYAN",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "PHARM.D., MPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-06-13",
        "last_updated": "2019-10-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "AZ",
            "license": "S019784",
            "primary": false
        },
        {
            "code": "1835P1200X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacotherapy",
            "state": "WA",
            "license": "PH60632918",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Toppenish, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2019; 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.