WALMART
NPI 1669871869
Pharmacist in Port Orchard, WA

Active since August 14, 2014CLIA 50D2174941 · Waiver
3497 BETHEL RD SE, PORT ORCHARD, WA 98366(360) 874-9063(360) 874-0071 Get Directions Write a Review

NPPES record last updated: August 14, 2014. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Walmart NPPES

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

WALMART (NPI 1669871869) is a healthcare organization registered as a pharmacist in Port Orchard, Washington and active in the NPI registry since August 2014. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Micajah Jenkins, Pharmacist, as its authorized official.

NPPES Registry Identity

NPI1669871869
Entity TypeOrganization
Primary Taxonomy183500000X
Legal Business NameWALMART
Location Address3497 BETHEL RD SEPort Orchard, WA 98366-5634
Mailing Address6690 Regency Dr Se, NonePort Orchard, WA 98367-9514 · (253) 509-2176
Fax(360) 874-0071
Organization SubpartNo
Authorized OfficialMicajah JenkinsPharmacist · (253) 509-2176
Enumeration DateAugust 14, 2014
NPI 1669871869 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacistPharmacy Service Providers
Taxonomy Code183500000X
License Licensed in WA · PH60031151
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.

3497 BETHEL RD SE, Port Orchard, WA 98366

Other Identifiers 1

OtherPH60031151WA · Pharmacist License

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 50D2174941

Walmart Pharmacy #10-2325 · Port Orchard, WA
Active · expires Apr 4, 2028
CLIA Number50D2174941
Laboratory TypePharmacy
Certificate Effective DateNovember 12, 2019
Certificate Expiration DateApril 4, 2028
Laboratory DirectorTony Tong
Laboratory Phone(360) 874-9063
Laboratory LocationWalmart Pharmacy #10-23253497 Bethel Rd SE, Port Orchard, WA 98366
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 7

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

Eyewear Supplier
3497 BETHEL RD SE
PORT ORCHARD, WA 98366
Pharmacist
3497 BETHEL RD SE
PORT ORCHARD, WA 98366
Pharmacist
3497 BETHEL RD SE
PORT ORCHARD, WA 98366
Optometrist
3497 BETHEL RD SE
PORT ORCHARD, WA 98366
Pharmacist
3497 BETHEL RD SE
PORT ORCHARD, WA 98366
Pharmacy (Community/Retail Pharmacy)
3497 BETHEL RD SE
PORT ORCHARD, WA 98366
Pharmacist
3497 BETHEL RD SE
PORT ORCHARD, WA 98366

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 Walmart's NPI number?

The NPI number for Walmart is 1669871869. It was assigned to this organization in the NPPES registry on August 14, 2014.

Where is Walmart located?

Walmart is located at 3497 Bethel Rd SE, Port Orchard, WA 98366. The listed phone number is (360) 874-9063.

What is Walmart's specialty?

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

Does Walmart hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2174941) is associated with this NPI, valid through April 4, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Walmart was last updated on August 14, 2014. NPI Profile syncs with the weekly NPPES data releases published by CMS.