Provider Demographics
NPI:1104400829
Name:MCEVER, JESSICA KATE
Entity Type:Individual
Prefix:
First Name:JESSICA
Middle Name:KATE
Last Name:MCEVER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10248 OLD NACHES HWY
Mailing Address - Street 2:
Mailing Address - City:NACHES
Mailing Address - State:WA
Mailing Address - Zip Code:98937-9700
Mailing Address - Country:US
Mailing Address - Phone:509-929-3001
Mailing Address - Fax:
Practice Address - Street 1:700 S MAIN ST
Practice Address - Street 2:
Practice Address - City:ELLENSBURG
Practice Address - State:WA
Practice Address - Zip Code:98926-3641
Practice Address - Country:US
Practice Address - Phone:509-925-4232
Practice Address - Fax:509-925-6063
Is Sole Proprietor?:No
Enumeration Date:2021-05-09
Last Update Date:2021-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician