Provider Demographics
NPI:1003191602
Name:WASHINGTON, SHEBA JORY (PHARM D)
Entity Type:Individual
Prefix:
First Name:SHEBA
Middle Name:JORY
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:PHARM D
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4213 SNOW GOOSE TRL
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:TX
Mailing Address - Zip Code:76005-1166
Mailing Address - Country:US
Mailing Address - Phone:708-710-2249
Mailing Address - Fax:
Practice Address - Street 1:6700 W VICKERY BLVD
Practice Address - Street 2:
Practice Address - City:FORT WORTH
Practice Address - State:TX
Practice Address - Zip Code:76116-9156
Practice Address - Country:US
Practice Address - Phone:817-576-4844
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-10-14
Last Update Date:2023-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL051291827183500000X
TX723361835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
No183500000XPharmacy Service ProvidersPharmacist