Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacob Sullivan, RPH

Individual provider Pharmacist · NPI 1164916656

Jacob Sullivan, RPH is a Pharmacist in Liberty Lake, Washington. Practices as a sole proprietor. Licensed in Washington.

Licensed in
WA
In the registry since
2018
What do these letters mean?
RPH — Registered Pharmacist
A pharmacist licensed by a state board.

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Practice location Address checks out

23102 E Appleway Ave
Liberty Lake, WA 99019-9585
Phone: (509) 928-8738
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pharmacist (primary) Taxonomy 183500000X · Licence PH00069866 (WA)

Record details

NPI number1164916656
Entity typeIndividual (Type 1)
GenderMale
Credentials RPH
Sole proprietorYes
NPI enumeratedJune 18, 2018
Last updated in NPPESJune 18, 2018
Mailing addressPo Box 608, Newman Lake, WA 99025-0608

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