Berry Dale Baxley, RPH

Key facts

NPI

1891765772

Entity type

Individual (NPI type 1)

Primary specialty

Pharmacist 183500000X

License

PH00020799 (WA)

Practice address

31515 20TH Ave S
Federal Way, WA 98003-5458

Phone

(253) 839-9322

NPI assigned

Jan 24, 2006

Sex

Male

Sole proprietor

No

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Haggen Inc Pharmacy · Federal Way, WA · NPI 1972536217
  NPD (past)

Medicare participation

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)

No

Credentials

Registered Pharmacist

State licenses

Practice roles

Specialties & licenses

Addresses

The complete NPPES record for this NPI in the NPI Registry API JSON format, last updated by the provider on Jul 13, 2026.

{
    "created_epoch": "1138060800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1783900800000",
    "number": "1891765772",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3714 SW 108TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981461754",
            "telephone_number": "206-241-5141"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "31515 20TH AVE S",
            "city": "FEDERAL WAY",
            "state": "WA",
            "postal_code": "980035458",
            "telephone_number": "253-839-9322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAXLEY",
        "first_name": "BERRY",
        "middle_name": "DALE",
        "name_prefix": "Mr.",
        "credential": "RPH",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-24",
        "last_updated": "2026-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH00020799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• John M Bauman, M.D.
• Aileen Bautista
• Curtis R. Baxstrom, OD
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• Yohannes Baye, NAR
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• Nicole Ann Bazzetta, ARNP

All providers in Federal Way, WA · Pharmacist in Washington