Active NPI
Branden Francis O'Brien Kennedy
- Pharmacist
- Tacoma, WA
National Provider Identifier
1639598956
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- 60472076
- Practice address
- 1821 Dock St
Unit 311
Tacoma, WA 98402-3201 - Phone
- (618) 698-9491
- NPI assigned
- Apr 15, 2014
- Last updated
- Jul 28, 2014
- Sex
- Male
- Sole proprietor
- Yes
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 | 60472076 | WA | Primary |
Addresses
Primary practice location
1821 Dock St
Unit 311
Tacoma, WA 98402-3201
Mailing address
1821 Dock St
Unit 311
Tacoma, WA 98402-3201
Phone (618) 698-9491
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 |
|---|---|---|---|
| 60472076 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1397520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1406505600000",
"number": "1639598956",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1821 DOCK ST",
"address_2": "UNIT 311",
"city": "TACOMA",
"state": "WA",
"postal_code": "984023201",
"telephone_number": "618-698-9491"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1821 DOCK ST",
"address_2": "UNIT 311",
"city": "TACOMA",
"state": "WA",
"postal_code": "984023201",
"telephone_number": "618-698-9491"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KENNEDY",
"first_name": "BRANDEN",
"middle_name": "FRANCIS O'BRIEN",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2014-04-15",
"last_updated": "2014-07-28",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "60472076",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Tacoma, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 28, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.