Organization
KELLEY-ROSS & ASSOC INC
Active
Other names
Kelley-Ross Pharmacy at the Polyclinic
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RYAN D OFTEBRO PHARMD (PRESIDENT)
(206) 622-3565
Entity
Organization
Contact information
Practice address
904 7TH AVE, SUITE 103, SEATTLE, WA 98104-1132
(206) 324-6990
(206) 329-1849
Mailing address
904 7TH AVE, SUITE 103, SEATTLE, WA 98104-1132
(206) 324-6990
(206) 329-1849
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
—
—
208U00000X
Clinical Pharmacology Physician
—
—
261Q00000X
Clinic/Center
—
—
333600000X
Pharmacy
Primary
CF00055786
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
6019087
—
WA
01
—
CF00055786
STATE PHARMACY
WA
Enumeration date
02/21/2007
Last updated
01/06/2021
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