Fred Meyer Stores Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00056557 Issued in WA

Legal business name

FRED MEYER STORES INC

Doing business as

Fred Meyer Pharmacy

Practice address

21045 Bothl Evrt Hwy
Bothell, WA 98021-8405

Phone

(425) 398-7033

Fax

(425) 398-7027

NPI assigned

Jun 21, 2006

Organization subpart

No

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

Authorized official

Name

Allison Muennich

Title

Manager of Pharmacy Licensing

Phone

(513) 762-1019

Specialties & licenses 3

Addresses

Other identifiers 2

Other names 1

• FRED MEYER PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WA2 enrollments

Enrollment records 2

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• The Kroger Co

  dba Kroger Pharmacy

  • Community/Retail Pharmacy
  • Woodstock, GA
  • NPI 1720012560

  Member Of

  NPD member

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Kathleen Nguyen

  • Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
  • Bothell, WA
  • NPI 1659628790
  NPD (past)
• Shaila S Shukla

  • Pharmacist
  • Bothell, WA
  • NPI 1326314857
  NPD (past)

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

{
    "created_epoch": "1150848000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1745280000000",
    "number": "1649216284",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 842772",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "022842772",
            "telephone_number": "513-762-1019",
            "fax_number": "513-762-1092"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "21045 BOTHL EVRT HWY",
            "city": "BOTHELL",
            "state": "WA",
            "postal_code": "980218405",
            "telephone_number": "425-398-7033",
            "fax_number": "425-398-7027"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FRED MEYER STORES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-06-21",
        "last_updated": "2025-04-22",
        "certification_date": "2025-04-22",
        "status": "A",
        "authorized_official_last_name": "MUENNICH",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_title_or_position": "MANAGER OF PHARMACY LICENSING",
        "authorized_official_telephone_number": "513-762-1019"
    },
    "taxonomies": [
        {
            "code": "332B00000X",
            "taxonomy_group": "",
            "desc": "Durable Medical Equipment & Medical Supplies",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00056557",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2110720",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6022792",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "FRED MEYER PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amanda Hope Fox, LMHCA
• Susie Fox, MS RD
• Makaila Foy
• Edniqua Fraser
• Fred Meyer Stores Inc (QFC Pharmacy)
• Julia P Fredrickson, DDS
• Ruth A. Freeman, M.D.
• Millicent Jane Frehner
• Andrew Leroy Frentz
• Eleonora Frick, LMHC

• Community/Retail Pharmacy in Bothell, WA
• Providers in Bothell, WA by specialty
• Community/Retail Pharmacy in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 22, 2025; 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.