Active NPI
Brett Louis Kittle
- Pharmacist
- Walla Walla, WA
National Provider Identifier
1790042273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- IR60155152
- Practice address
- 195 Assumption Dr
Walla Walla, WA 99362-2608 - Phone
- (509) 540-2809
- NPI assigned
- Apr 20, 2012
- Sex
- Male
- Sole proprietor
- No
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 | IR60155152 | WA | Primary |
Addresses
Primary practice location
195 Assumption Dr
Walla Walla, WA 99362-2608
Mailing address
195 Assumption Dr
Walla Walla, WA 99362-2608
Phone (509) 540-2809
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| E15709 | Other | ID | IDAHO STATE BOARD OF PHARMACY |
| IR60155152 | Other | WA | WASHINGTON STATE BOARD OF PHARMACY |
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 |
|---|---|---|---|
| IR60155152 | WA | MD | Pharmacist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1334880000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1334880000000",
"number": "1790042273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "195 ASSUMPTION DR",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622608",
"telephone_number": "509-540-2809"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "195 ASSUMPTION DR",
"city": "WALLA WALLA",
"state": "WA",
"postal_code": "993622608",
"telephone_number": "509-540-2809"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITTLE",
"first_name": "BRETT",
"middle_name": "LOUIS",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2012-04-20",
"last_updated": "2012-04-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "WA",
"license": "IR60155152",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IDAHO STATE BOARD OF PHARMACY",
"identifier": "E15709",
"state": "ID"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "WASHINGTON STATE BOARD OF PHARMACY",
"identifier": "IR60155152",
"state": "WA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Walla Walla, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.