Organization
KELLEY-ROSS AND ASSOC, INC.
Active
Other names
Kelley-Ross Compounding Pharmacy
Organization subpart
No
Provider details
NPI number
Authorized official
RYAN OFTEBRO (PRESIDENT)
(206) 622-3565
Entity
Organization
Contact information
Practice address
805 MADISON ST # 702, SEATTLE, WA 98104-1172
(206) 622-3565
Mailing address
805 MADISON ST # 702, SEATTLE, WA 98104-1172
(206) 622-3565
Taxonomy
Speciality
Code
Description
License number
State
3336C0004X
Compounding Pharmacy
Primary
PHARCF60434600
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2143617
PK
—
Enumeration date
01/06/2014
Last updated
03/13/2022
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