JESSE WITYCZAK (NPI# 1558724302) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1558724302 |
| Entity Type | Individual |
| Full Name | JESSE WITYCZAK |
| Credential | PHARMD |
| Practice Address |
101 Bolstad Ave E Long Beach WA 98631 |
| Mailing Address |
1433 12th Ave Apt. 302 Seattle WA 98122-3961 |
| Practice Telephone | 3606422349 |
| Mailing Telephone | 2088166884 |
| Enumeration Date | 2016-03-30 |
| Last Update Date | 2016-03-30 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835P2201X |
Pharmacist Specialization: Ambulatory Care |
PH60465766 | WA | Pharmacy Service Providers |
| Street Address |
101 BOLSTAD AVE E |
| City | LONG BEACH |
| State | WA |
| Zip Code | 98631 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1063048197 | Peninsula Pharmacies Inc Long Beach Pharmacy Annex | Pharmacy | 110 Oregon Ave S, Long Beach, WA 98631 | 2020-03-20 |
| 1033755244 | Willapa Behavioral Health | Peer Specialist | 2204 Pacific Ave. N., Long Beach, WA 98631 | 2019-11-22 |
| 1427576362 | Susan Amy Goldsmith | Social Worker | 607 Ocean Beach Blvd. N., Long Beach, WA 98631 | 2017-08-30 |
| 1659618007 | Teresa Mary Fleck | Speech-Language Pathologist | 400 S Washington, Long Beach, WA 98631 | 2013-01-04 |
| 1639400385 | Wendy Liu | Counselor | 2204 Pacififc Avenue N, Long Beach, WA 98631 | 2010-01-20 |
| 1093046088 | Diane L Adams | Counselor | 2204 Pacific Avenue N, Long Beach, WA 98631 | 2010-01-15 |
| 1538498076 | Steven R Fox | Counselor | 22004 Pacific Way N, Long Beach, WA 98631 | 2009-12-11 |
| 1295907137 | Brandon L Adams Md Ps | General Practice | 105 6th St, Long Beach, WA 98631 | 2008-04-01 |
| 1710188263 | Willapa Counseling Center | Clinic/Center | 1107 Pacific Avenue North, Long Beach, WA 98631 | 2007-05-31 |
| 1720204779 | Darren L Thorsen, Od | Optometrist | 1703 South Pacific Ave, Long Beach, WA 98631 | 2007-04-18 |
| Find all providers in zip 98631 | ||||
| Taxonomy Code | 1835P2201X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Ambulatory Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the provision of integrated, accessible health care services by pharmacists and is accountable for addressing medication needs, developing sustained partnerships with patients, and practicing in the context of family and community. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [7/1/2015: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1164973822 | Tracy Pham | Pharmacist | 1750 Pacific Ave # A, Long Beach, CA 90813-1715 | 2016-10-18 |
| 1508429150 | Kelly Tran | Pharmacist | 3575 Atlantic Ave, Long Beach, CA 90807-4515 | 2019-04-18 |
| 1023508330 | Laura Sezonov | Pharmacist | 2699 Atlantic Ave, Long Beach, CA 90806-2710 | 2018-05-11 |
| 1275086860 | Larry Lovett | Pharmacist | 2801 Atlantic Ave, Long Beach, CA 90806-1701 | 2016-07-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245839935 | Zackary Beard | Pharmacist | 17700 Se 272nd St # 100, Covington, WA 98042-4951 | 2020-10-22 |
| 1073110581 | Vince Pinaroc | Pharmacist | 4545 Pt Fosdick Dr Nw Ste 250, Gig Harbor, WA 98335-1700 | 2020-10-07 |
| 1881212751 | Jordan C Smith | Pharmacist | 105 W 8th Ave # 350e, Spokane, WA 99204-2302 | 2020-07-08 |
| 1255976056 | Olusegun Adesesan Bamgbelu | Pharmacist | Memorial Cornerstone Pharmacy, 4003 Creekside Loop, Yakima, WA 98908 | 2019-11-15 |
| 1922586023 | Kimberly Jane Comito | Pharmacist | 1002 15th St Sw Ste 101, Auburn, WA 98001-6502 | 2018-07-31 |
| 1760974315 | Rachna Burman I | Pharmacist | 1708 Yakima Ave Ste 20, Tacoma, WA 98405-5307 | 2018-05-30 |
| 1942792676 | John K Guffey | Pharmacist | 12607 Se Mill Pain Blvd, Vancouver, WA 98684-4098 | 2018-05-30 |
| 1790297232 | Racha Aldughli | Pharmacist | 1901 S Union Ave Ste 7009, Tacoma, WA 98405-1702 | 2017-10-24 |
| 1881104297 | Beverly Moua | Pharmacist | 207 E Stanley St, Granite Falls, WA 98252-8480 | 2017-10-11 |
| 1992220214 | Rachel Ann Alm | Pharmacist | 525 Lilly Rd Ne Ste 204, Olympia, WA 98506-5101 | 2017-08-08 |
| Find all providers with the same taxonomy | ||||
| City | LONG BEACH |
| Zip Code | 98631 |
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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.