KELLEY-ROSS COMPOUNDING PHARMACY
NPI 1730500067
Pharmacy - Compounding Pharmacy in Seattle, WA

Active since January 06, 2014CLIA 50D2102213 · Waiver
805 MADISON ST # 702, SEATTLE, WA 98104(206) 622-3565 Get Directions Write a Review

NPPES record last updated: March 13, 2022. Verified against the NPPES registry weekly; last sync: July 26, 2026.

About Kelley-ross Compounding Pharmacy NPPES

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

KELLEY-ROSS COMPOUNDING PHARMACY (NPI 1730500067) is a healthcare organization registered as a compounding pharmacy in Seattle, Washington and active in the NPI registry since January 2014. The organization holds a CLIA Waiver certificate valid through April 4, 2028 and lists Ryan Oftebro, President, as its authorized official.

NPPES Registry Identity

NPI1730500067
Entity TypeOrganization
Primary Taxonomy3336C0004X
Legal Business NameKELLEY-ROSS AND ASSOC, INC.
Location Address805 MADISON ST # 702Seattle, WA 98104-1172
Mailing Address805 Madison St # 702Seattle, WA 98104-1172 · (206) 622-3565
Organization SubpartNo
Authorized OfficialRyan OftebroPresident · (206) 622-3565
Enumeration DateJanuary 6, 2014
Last NPPES UpdateMarch 13, 2022
NPPES CertifiedMarch 13, 2022
NPI 1730500067 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPharmacy · Compounding PharmacySuppliers
Taxonomy Code3336C0004X
License Licensed in WA · PHARCF60434600
Definition

A pharmacy that specializes in the preparation of components into a drug preparation as the result of a Practitioner's Prescription Drug Order or initiative based on the Practitioner/Patient/Pharmacist relationship in the course of professional practice. A compounding pharmacy utilizes specialized equipment and specially designed facilities necessary to meet the legal and quality requirements of its scope of compounding practice.

805 MADISON ST # 702, Seattle, WA 98104

Other Names 1

Doing Business AsKelley-ross Compounding Pharmacy

Other Identifiers 1

Other2143617Pk

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 50D2102213

Kelley-Ross Compounding Pharmacy · Seattle, WA
Active · expires Apr 4, 2028
CLIA Number50D2102213
Laboratory TypePharmacy
Certificate Effective DateSeptember 17, 2015
Certificate Expiration DateApril 4, 2028
Laboratory DirectorScott Herzog
Laboratory Phone(206) 622-3565
Laboratory LocationKelley-Ross Compounding Pharmacy805 Madison St # 702, Seattle, WA 98104
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

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

Pharmacist
805 MADISON ST # 702
SEATTLE, WA 98104

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 Kelley-Ross And Assoc, Inc.'s NPI number?

The NPI number for Kelley-Ross And Assoc, Inc. is 1730500067. It was assigned to this organization in the NPPES registry on January 6, 2014. The provider is doing business as Kelley-Ross Compounding Pharmacy.

Where is Kelley-Ross And Assoc, Inc. located?

Kelley-Ross And Assoc, Inc. is located at 805 Madison St # 702, Seattle, WA 98104. The listed phone number is (206) 622-3565.

What is Kelley-Ross And Assoc, Inc.'s specialty?

The primary specialty registered for this NPI is Pharmacy, specializing in Compounding Pharmacy, with taxonomy code 3336C0004X.

Does Kelley-Ross And Assoc, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 50D2102213) 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 Kelley-Ross And Assoc, Inc. was last updated on March 13, 2022. NPI Profile syncs with the weekly NPPES data releases published by CMS.