Individual provider Active NPI

Elaine Margaret Kelley, RPH

  • Pharmacist
  • Spokane Valley, WA
National Provider Identifier
1992071013
Registry record updated Mar 23, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
10964 Issued in WA
Practice address
15609 E Sprague Ave
Spokane Valley, WA 99037-5003
Phone
(509) 921-5383
NPI assigned
Mar 23, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 23, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 10964 WA Primary

Addresses

Primary practice location

15609 E Sprague Ave
Spokane Valley, WA 99037-5003

Mailing address

15508 E 11TH Ave
Spokane Valley, WA 99037-9217
Phone (509) 863-2408

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
Credentials
Registered Pharmacist

State licenses

LicenseStateTypeSpecialty
10964WAMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1332460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1332460800000",
    "number": "1992071013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15508 E 11TH AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990379217",
            "telephone_number": "509-863-2408"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "15609 E SPRAGUE AVE",
            "city": "SPOKANE VALLEY",
            "state": "WA",
            "postal_code": "990375003",
            "telephone_number": "509-921-5383"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KELLEY",
        "first_name": "ELAINE",
        "middle_name": "MARGARET",
        "credential": "RPH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-03-23",
        "last_updated": "2012-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "10964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane Valley, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 23, 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.

Verify at the official NPI Registry.