Kalama Pharmacy Inc

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

PHAR.CF.00001831 Issued in WA

Legal business name

KALAMA PHARMACY INC

Doing business as

GODFREYS
KALAMA PHARMACY

Practice address

270 N 1St St
Kalama, WA 98625-9100

Phone

(360) 673-2600

Fax

(360) 673-2601

NPI assigned

Aug 20, 2006

Organization subpart

No

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

Authorized official

Name

Jonathon Rodeback

Title

Owner

Phone

(360) 673-2600

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 3

• GODFREYS Doing business as
• KALAMA PHARMACY Doing business as
• GODFREYS PHARMACY Former legal business name

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

{
    "created_epoch": "1156032000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1776643200000",
    "number": "1801901855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1759",
            "city": "KALAMA",
            "state": "WA",
            "postal_code": "986251500",
            "telephone_number": "360-673-2600",
            "fax_number": "360-673-2601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "270 N 1ST ST",
            "city": "KALAMA",
            "state": "WA",
            "postal_code": "986259100",
            "telephone_number": "360-673-2600",
            "fax_number": "360-673-2601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KALAMA PHARMACY INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-20",
        "last_updated": "2026-04-20",
        "certification_date": "2026-04-20",
        "status": "A",
        "authorized_official_last_name": "RODEBACK",
        "authorized_official_first_name": "JONATHON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-673-2600"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "PHAR.CF.00001831",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6052302",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2106791",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "GODFREYS",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "KALAMA PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "GODFREYS PHARMACY",
            "code": "4",
            "type": "Former Legal Business Name"
        }
    ]
}

• Jerry Ezell Jr., RN
• Michael Falter, D.M.D.
• Rochelle Grothaus, RN
• David Lawrence Hodgson, LMHCA
• Chelsei Gene Jackson-Day, CDPT
• Kalama School District
• Brenda Kaye Larson, MA
• Jeremy Levin
• Tracie Lynn Payne, RN
• Colleen Emily Peterson, LMT

• Community/Retail Pharmacy in Kalama, WA
• Providers in Kalama, 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 20, 2026; 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.