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JACOB SULLIVAN RPH
NPI 1164916656
Pharmacist in Liberty Lake, WA

Active since June 18, 2018
23102 E APPLEWAY AVE, LIBERTY LAKE, WA 99019(509) 928-8738 Get Directions Write a Review

NPPES record last updated: June 18, 2018. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jacob Sullivan Rph NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JACOB SULLIVAN RPH (NPI 1164916656) is an individual pharmacist in Liberty Lake, Washington, licensed in Washington (PH00069866) and active in the NPI registry since June 2018.

NPPES Registry Identity

NPI1164916656
Entity TypeIndividualMale
Primary Taxonomy183500000X
Provider Legal NameJACOB SULLIVANCredential: RPH
Location Address23102 E APPLEWAY AVELiberty Lake, WA 99019-9585
Mailing AddressPo Box 608Newman Lake, WA 99025-0608 · (509) 981-8315
Phone(509) 928-8738
Sole ProprietorYes
Enumeration DateJune 18, 2018
✔ NPI 1164916656 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License✔ Licensed in WA · PH00069866
Definition
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.
23102 E APPLEWAY AVE, Liberty Lake, WA 99019
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Other Providers at the Same Location NPPES 2

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

BELLEVUE HEALTHCARE II INC
Durable Medical Equipment & Medical Supplies
23102 E APPLEWAY AVE
LIBERTY LAKE, WA 99019
Spokane County (509) 327-7799
CRAIG BROOM
Pharmacist
23102 E APPLEWAY AVE
LIBERTY LAKE, WA 99019
Spokane County (509) 928-8738

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jacob Sullivan's NPI number?

The NPI number for Jacob Sullivan is 1164916656. It was assigned to this individual provider in the NPPES registry on June 18, 2018.

Where is Jacob Sullivan located?

Jacob Sullivan practices at 23102 E Appleway Ave, Liberty Lake, WA 99019. The listed phone number is (509) 928-8738.

What is Jacob Sullivan's specialty?

The primary specialty registered for this NPI is Pharmacist with taxonomy code 183500000X.

When was this NPI record last updated?

The NPPES record for Jacob Sullivan was last updated on June 18, 2018. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.