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NPI Code Detail

MEDICARE: KELLEY-ROSS & ASSOC INC

MEDICARE: KELLEY-ROSS & ASSOC INC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1333600000XPharmacyCF00003637WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14907929OTHERNCPDP
2CF00003637OTHERWASTATE PHARMACY

General Provider Information

NPI Number : 1497890941
Entity Type Code : Organization
Provider Name (Legal Business Name) : KELLEY-ROSS & ASSOC INC
Provider Business Mailing Address
First Line : 2324 EASTLAKE AVE E
Second Line : SUITE 405
City : SEATTLE
State : WA
Zip : 98102-3345
Country : US
Telephone Number : 206-441-9174
Fax Number : 206-448-4406
Provider Business Practice Location Address
First Line : 2324 EASTLAKE AVE E
Second Line : SUITE 405
City : SEATTLE
State : WA
Zip : 98102-3345
Country : US
Telephone Number : 206-441-9174
Fax Number : 206-448-4406
Authorized Official
Title or Position : PRESIDENT
Name : DR. RYAN D OFTEBRO
Credential : PHARMD
Telephone Number : 206-622-3565
Provider Enumeration Date : 02/21/2007
Last Update Date : 04/22/2021

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Directions to “KELLEY-ROSS & ASSOC INC ” Practice Location

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