Individual provider Active NPI

Jenny Rose Calayag, PHARMD

  • Pharmacist
  • Federal Way, WA
National Provider Identifier
1730706557
Registry record updated Jan 4, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH60570005 Issued in WA
Practice address
33520 21St Ave SW
Federal Way, WA 98023-2874
Phone
(253) 838-1611
NPI assigned
Jun 26, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 4, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH60570005 WA Primary

Addresses

Primary practice location

33520 21St Ave SW
Federal Way, WA 98023-2874

Mailing address

33520 21St Ave SW
Federal Way, WA 98023-2874
Phone (253) 838-1611

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
PH60570005WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1593129600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1609718400000",
    "number": "1730706557",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "33520 21ST AVE SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232874",
            "telephone_number": "253-838-1611"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "33520 21ST AVE SW",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980232874",
            "telephone_number": "253-838-1611"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CALAYAG",
        "first_name": "JENNY ROSE",
        "credential": "PHARMD",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-06-26",
        "last_updated": "2021-01-04",
        "certification_date": "2021-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH60570005",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Federal Way, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 4, 2021; 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.