Active NPI
Kelley-Ross & Assoc Inc
- Pharmacy
- Seattle, WA
National Provider Identifier
1770579526
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacy
- License
- CF00001255
- Legal business name
- KELLEY-ROSS & ASSOC INC
- Doing business as
- Kelley-Ross Pharmacy - Downtown
- Practice address
- 616 Olive Way
Seattle, WA 98101-1717 - Phone
- (206) 622-3565
- Fax
- (206) 382-9727
- NPI assigned
- Sep 26, 2005
- Organization subpart
- Yes
- Parent organization
- KELLEY-ROSS & ASSOC INC
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mr. Ryan D Oftebro, PHARM.D.
- Title
- President
- Phone
- (206) 622-3565
Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacy | 333600000X | CF00001255 | WA | Primary |
Addresses
Primary practice location
616 Olive Way
Seattle, WA 98101-1717
Mailing address
616 Olive Way
Seattle, WA 98101-1717
Phone (206) 622-3565
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 6015308 | Medicaid | WA |
Other names 1
- Kelley-Ross Pharmacy - Downtown
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20071102000148 | WA | Part B Supplier - Mass Immunization (Roster Biller Only) | 1456448703 |
1 other NPI on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Seattle, WA |
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- Part of
- Island Prescription Pha
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
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- Seattle, WA
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- NPI 1013050350
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- Pharmacist
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- NPI 1689836447
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- Pharmacist
- Seattle, WA
- NPI 1376724856
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1127692800000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1226534400000",
"number": "1770579526",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "616 OLIVE WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981011717",
"telephone_number": "206-622-3565",
"fax_number": "206-382-9727"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "616 OLIVE WAY",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981011717",
"telephone_number": "206-622-3565",
"fax_number": "206-382-9727"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "KELLEY-ROSS & ASSOC INC",
"organizational_subpart": "YES",
"parent_organization_legal_business_name": "KELLEY-ROSS & ASSOC INC",
"enumeration_date": "2005-09-26",
"last_updated": "2008-11-13",
"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": "Mr.",
"authorized_official_credential": "PHARM.D."
},
"taxonomies": [
{
"code": "333600000X",
"taxonomy_group": "",
"desc": "Pharmacy",
"state": "WA",
"license": "CF00001255",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "6015308",
"state": "WA"
}
],
"endpoints": [],
"other_names": [
{
"organization_name": "Kelley-Ross Pharmacy - Downtown",
"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 Nov 13, 2008; 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.