Provider Demographics
NPI:1083909162
Name:WALKER, JARED W (PHARMD)
Entity Type:Individual
Prefix:MR
First Name:JARED
Middle Name:W
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7409 W VIRGINIA AVE
Mailing Address - Street 2:T-0851
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85035-1336
Mailing Address - Country:US
Mailing Address - Phone:623-245-3033
Mailing Address - Fax:
Practice Address - Street 1:7409 W VIRGINIA AVE
Practice Address - Street 2:T-0851
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85035-1336
Practice Address - Country:US
Practice Address - Phone:623-245-3033
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-16
Last Update Date:2011-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ016603183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist