TIMOTHY THOMAS CAVANAGH JR. (NPI# 1003220757) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1003220757 |
| Entity Type | Individual |
| Full Name | TIMOTHY THOMAS CAVANAGH JR. |
| Credential | PHARMD |
| Practice Address |
9040a Jackson Ave Joint Base Lewis Mcchord WA 98431-0001 |
| Practice Telephone | 2539682999 |
| Mailing Telephone | 2539682999 |
| Enumeration Date | 2014-06-19 |
| Last Update Date | 2020-06-04 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | PH100001712 | DC | Pharmacy Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 1815 Connecticut Ave Nw, Washington, DC 200095702 | 2022321718 | 2023329033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699803700 | Timothy Robert Cavanagh | Family Medicine | 483 West Seed Farm Road, Sacaton, AZ 85147-0115 | 2007-03-01 |
| Street Address |
9040A JACKSON AVE |
| City | JOINT BASE LEWIS MCCHORD |
| State | WA |
| Zip Code | 98431-0001 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336747716 | Melissa Stahl | Occupational Therapist | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2020-10-16 |
| 1043832090 | Ryan Michael Brock | Pharmacist | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2020-05-13 |
| 1205457900 | Yang Qu | Physician Assistant | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2020-05-04 |
| 1275195877 | Michael C Saenz | Licensed Practical Nurse | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2019-07-03 |
| 1154892792 | Nicholas James Wankum | Physical Therapist | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2018-12-07 |
| 1942775184 | Rachel Nell Dyal | Nutritionist | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2018-10-03 |
| 1861998346 | Isaac Ingersoll | General Practice | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2018-04-03 |
| 1184124687 | Ketan Mehta | General Practice | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2018-02-20 |
| 1073965851 | Katy L Modlin | Dermatology | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-5638 | 2016-07-06 |
| 1104286582 | Andrew Zilka | Physician Assistant | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2016-02-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| 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. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043832090 | Ryan Michael Brock | Pharmacist | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2020-05-13 |
| 1316496177 | Megan Claire Theus | Pharmacist | 9040 Jackson Ave, Joint Base Lewis Mcchord, WA 98431-1000 | 2016-09-21 |
| 1386053379 | Sarah Abel | Pharmacist | 9040 Jackson Ave, Joint Base Lewis Mcchord, WA 98431 | 2014-08-05 |
| 1851712012 | Sarah Steger | Pharmacist | 9040 Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2013-12-13 |
| 1770913014 | Cathy Nguyen | Pharmacist | 9040 Reid St, Attn: Mchj-clq-c (madigan Army Medical Center), Joint Base Lewis Mcchord, WA 98431-1101 | 2013-11-23 |
| 1235419615 | Katelynn Blume Eberle | Pharmacist | 9040 Jackson Ave, Joint Base Lewis Mcchord, WA 98431-1000 | 2011-08-17 |
| 1356620918 | Kyle Richard Nebelsick | Pharmacist | 9040 Jackson Ave, Joint Base Lewis Mcchord, WA 98431-1100 | 2011-08-12 |
| 1538479621 | Jonathan Scott Bartlett | Pharmacist | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2010-10-07 |
| 1497069710 | Erica Orthman | Pharmacist | 9040 Reid St # A, Joint Base Lewis Mcchord, WA 98431-1100 | 2010-07-28 |
| 1528097326 | Ricke J. Weickum | Pharmacist | 9040 Jackson Ave, 8-north, Ipmc, Joint Base Lewis Mcchord, WA 98431-0001 | 2006-07-02 |
| Find all providers in JOINT BASE LEWIS MCCHORD | ||||
| City | JOINT BASE LEWIS MCCHORD |
| Zip Code | 98431 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.