NPIMap

Organization Active NPI

Kelley-Ross & Assoc Inc

Doing business as Union Center Pharmacy

  • Pharmacy
  • Seattle, WA
National Provider Identifier
1497890941
Registry record updated Apr 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacyTaxonomy code 333600000X
License
CF00003637 Issued in WA
Legal business name
KELLEY-ROSS & ASSOC INC
Doing business as
Union Center Pharmacy
Practice address
2324 Eastlake Ave E
Suite 405
Seattle, WA 98102-3345
Phone
(206) 441-9174
Fax
(206) 448-4406
NPI assigned
Feb 21, 2007
Last updated
Apr 22, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 22, 2021

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

Authorized official

Name
Dr. Ryan D Oftebro, PHARMDNPI 1679560882
Title
President
Phone
(206) 622-3565

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacy 333600000X CF00003637 WA Primary

Addresses

Primary practice location

2324 Eastlake Ave E
Suite 405
Seattle, WA 98102-3345

Mailing address

2324 Eastlake Ave E
Suite 405
Seattle, WA 98102-3345
Phone (206) 441-9174

Other names 1

  • Union Center Pharmacy Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210623001977 WA Part B Supplier - Pharmacy 1456448703 1 other NPI on this enrollment
Practice locations: Seattle, WA

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

2324 Eastlake Ave E
Ste 405
Seattle, WA 98102
Phone (206) 441-9174

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1619049600000",
    "number": "1497890941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2324 EASTLAKE AVE E",
            "address_2": "SUITE 405",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023345",
            "telephone_number": "206-441-9174",
            "fax_number": "206-448-4406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2324 EASTLAKE AVE E",
            "address_2": "SUITE 405",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981023345",
            "telephone_number": "206-441-9174",
            "fax_number": "206-448-4406"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KELLEY-ROSS & ASSOC INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2021-04-22",
        "certification_date": "2021-04-22",
        "status": "A",
        "authorized_official_last_name": "OFTEBRO",
        "authorized_official_first_name": "RYAN",
        "authorized_official_middle_name": "D",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "206-622-3565",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "WA",
            "license": "CF00003637",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Union Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Union Center Pharmacy",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Seattle, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.