DR. ERIK DANIEL KELLISON (NPI# 1144652629) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1144652629 |
Entity Type | Individual |
Full Name | DR. ERIK DANIEL KELLISON |
Credential | PHARMD |
Practice Address |
1802 Yakima Ave Suite 302 Tacoma WA 98405-4499 |
Practice Telephone | 2536271244 |
Practice Fax Number | 2537796221 |
Mailing Telephone | 2536271244 |
Mailing Fax Number | 2537796221 |
Enumeration Date | 2013-08-06 |
Last Update Date | 2017-01-26 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 183500000X | Pharmacist | PH60389489 | WA | Pharmacy Service Providers |
State | Issuer | Identifier | Type Code |
---|---|---|---|
WA | DEA | MK3269190 | 01 |
WA | WA STATE PHARMACIST LICENSE # | PH60389489 | 01 |
Street Address |
1802 YAKIMA AVE SUITE 302 |
City | TACOMA |
State | WA |
Zip Code | 98405-4499 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1356346936 | James Gregory Roberts | Surgery | 1802 Yakima Ave, Ste 204, Tacoma, WA 98405-4499 | 2005-06-20 |
1215393111 | Catherine Rehberger | Nurse Practitioner | 1802 Yakima Ave, 102, Tacoma, WA 98405-4499 | 2016-01-07 |
1548665318 | Franciscan Health System | Durable Medical Equipment & Medical Supplies | 1802 Yakima Ave, Suite 201, Tacoma, WA 98405-4499 | 2014-10-23 |
1679837868 | Ashley Kay Kauzlaric | Nurse Practitioner | 1802 Yakima Ave, Suite 302, Tacoma, WA 98405-4499 | 2012-07-02 |
1225398589 | Franciscan Medical Group | Internal Medicine | 1802 Yakima Ave, Suite 304, Tacoma, WA 98405-4499 | 2012-05-21 |
1770850570 | Sarah Jones Lahnert | Physician Assistant | 1802 Yakima Ave, Suite 302, Tacoma, WA 98405-4499 | 2011-11-22 |
1760768402 | Franciscan Medical Group | Surgery | 1802 Yakima Ave, Ste 204, Tacoma, WA 98405-4499 | 2011-10-26 |
1881989945 | Franciscan Medical Group | Internal Medicine | 1802 Yakima Ave, Ste 307, Tacoma, WA 98405-4499 | 2011-06-16 |
1699060756 | Franciscan Medical Group | Internal Medicine | 1802 Yakima Ave, Ste 302, Tacoma, WA 98405-4499 | 2011-06-16 |
1255639456 | Franciscan Medical Group | Internal Medicine | 1802 Yakima Ave, Ste 208, Tacoma, WA 98405-4499 | 2011-03-11 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1609486026 | Joanna Christine Hope | Physician Assistant | 2502 S Union Avenue, Tacoma, WA 98405 | 2020-08-01 |
1467077891 | Richard Jimenez | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way Suite #310, Tacoma, WA 98405 | 2020-06-11 |
1669008785 | Mariana Sanchez Corona | Behavior Technician | 1901 S Union Ave Allenmore Building B, Tacoma, WA 98405 | 2020-03-20 |
1811534845 | Jasmine Gregory | Social Worker | 311 Martin Luther King Jr. Way, Ms:315-c2-php, Tacoma, WA 98405 | 2019-12-10 |
1548807506 | Holly Rebecca Brezynski | Student in an Organized Health Care Education/Training Program | Fresenius Kindney Care - Home Therapies Department, 1717 South J Street, Tacoma, WA 98405 | 2019-12-09 |
1972064392 | Logan Brau | Student in an Organized Health Care Education/Training Program | 1202 M.l.k. Jr Way, Tacoma, WA 98405 | 2019-03-28 |
1629532536 | Preferred Orthotic and Prosthetic Services Inc | Prosthetic/Orthotic Supplier | 1708 Yakima Ave Ste 60, Tacoma, WA 98405 | 2019-01-24 |
1669945911 | Heidi Weakley | Counselor | 1001 S Yakima Ave, Suite 5, Tacoma, WA 98405 | 2019-01-09 |
1972074011 | Taviance Benet Laster | Behavior Technician | 1416 S 9th St, Tacoma, WA 98405 | 2018-12-16 |
1336618040 | Bailey Bangerter | Physician Assistant | 1901 South Union, A-233, Tacoma, WA 98405 | 2018-11-26 |
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Taxonomy Code | 183500000X |
Grouping | Pharmacy Service Providers |
Classification | Pharmacist |
An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1275008070 | Kristi Anne Escalante | Pharmacist | 2368 Yakima Ave Unit 714, Tacoma, WA 98405-3966 | 2018-10-08 |
1851890180 | Chae Yun Kim | Pharmacist | 1902 96th St S, Tacoma, WA 98444-2808 | 2018-02-01 |
1407367980 | Heather Tilley | Pharmacist | 1717 S J St # Ms 01-79, Tacoma, WA 98405-4933 | 2017-10-23 |
1477097756 | Debra M Hines | Pharmacist | 9040a Jackson, Tacoma, WA 98431-0001 | 2016-12-06 |
1154879575 | Min Shim | Pharmacist | 3806 E L St, Tacoma, WA 98404-3735 | 2016-09-14 |
1689129413 | Amanda Nguyen | Pharmacist | 1901 S Union Ave Ste A252, Tacoma, WA 98405-1713 | 2016-08-22 |
1649659301 | Shirley So | Pharmacist | 315 Mlk. Jr Way, Tacoma, WA 98405-9997 | 2015-05-27 |
1245623628 | David Johnson | Pharmacist | 10223 50th Ave E, Tacoma, WA 98446-5412 | 2015-03-10 |
1972995967 | Tuyen Huynh | Pharmacist | 1608 South J St, Tacoma, WA 98405 | 2015-02-27 |
1396134060 | Chun Choi | Pharmacist | 13817 12th Ave S, Tacoma, WA 98444-2044 | 2015-01-17 |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.