Bob Johnsons Pharmacy

Primary specialty

Community/Retail PharmacyTaxonomy code 3336C0003X

License

CF00003305 Issued in WA

Legal business name

BOB JOHNSONS PHARMACY

Doing business as

Bob Johnsons Pharmacy

Practice address

1407 NW 85TH St
Seattle, WA 98117-4237

Phone

(206) 782-5822

Fax

(206) 781-0379

NPI assigned

Aug 10, 2006

Last updated

Jun 10, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jeffrey Shane Harrell, PHARMD

Title

Owner

Phone

(360) 859-8659

Specialties & licenses 2

Addresses

Other identifiers 2

Other names 1

• BOB JOHNSONS PHARMACY Doing business as

Medicare fee-for-service enrollment

Enrolled in WA

Enrollment records 1

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Jessica Caitlin Halstead, PHARMD

  • Pharmacist
  • Seattle, WA
  • NPI 1811244379
  NPD (past)
• Dana Hammer, RPH, PHD

  • Pharmacist
  • Seattle, WA
  • NPI 1548719123
  NPD (past)
• Elizabeth Sullivan, PHARMD

  • Pharmacist
  • Seattle, WA
  • NPI 1639904709
  NPD (past)
• Ali Lois Icenogle, PHARMACIST

  • Pharmacist
  • Tucson, AZ
  • NPI 1053824003
  NPD (past)

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

{
    "created_epoch": "1155168000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781049600000",
    "number": "1932110434",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX B",
            "city": "ILWACO",
            "state": "WA",
            "postal_code": "986240167",
            "telephone_number": "206-782-5822",
            "fax_number": "206-781-0379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1407 NW 85TH ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981174237",
            "telephone_number": "206-782-5822",
            "fax_number": "206-781-0379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BOB JOHNSONS PHARMACY",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-10",
        "last_updated": "2026-06-10",
        "certification_date": "2026-06-10",
        "status": "A",
        "authorized_official_last_name": "HARRELL",
        "authorized_official_first_name": "JEFFREY",
        "authorized_official_middle_name": "SHANE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "360-859-8659",
        "authorized_official_credential": "PHARMD"
    },
    "taxonomies": [
        {
            "code": "333600000X",
            "taxonomy_group": "",
            "desc": "Pharmacy",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "3336C0003X",
            "taxonomy_group": "",
            "desc": "Pharmacy, Community/Retail Pharmacy",
            "state": "WA",
            "license": "CF00003305",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PK",
            "identifier": "2108490",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "6030654",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "BOB JOHNSONS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "BOB JOHNSONS PHARMACY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Luke C. Boardman
• Emily Boardway
• Zachary Petrone Boas, M.D.
• Emmanuel Boateng, MD
• Forson Addae Boateng, RN-REGISTERED NURSE
• Bob Johnsons Pharmacy Inc
• Bob's Psychotherapy
• Valerie L Bobb, PHYSICAL THERAPIST
• Bobbi M. Smith Counseling
• Bobby L. Butler, DDS PLLC

• Community/Retail Pharmacy in Seattle, WA
• Providers in Seattle, 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 Jun 10, 2026; 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.

Verify at the official NPI Registry.