Provider Demographics
NPI:1093459810
Name:YANIT, JESSICA JOY SALALILA (PHARMD)
Entity Type:Individual
Prefix:
First Name:JESSICA JOY
Middle Name:SALALILA
Last Name:YANIT
Suffix:
Gender:F
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:PO BOX 21201
Mailing Address - Street 2:
Mailing Address - City:BARRIGADA
Mailing Address - State:GU
Mailing Address - Zip Code:96921-1201
Mailing Address - Country:US
Mailing Address - Phone:671-988-6223
Mailing Address - Fax:
Practice Address - Street 1:541 S MARINE CORPS DR
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3521
Practice Address - Country:US
Practice Address - Phone:671-646-6337
Practice Address - Fax:671-648-6337
Is Sole Proprietor?:Yes
Enumeration Date:2022-04-27
Last Update Date:2022-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUPH0472183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist