Provider Demographics
NPI:1508238296
Name:BOWN, JALENA J (PH60473403)
Entity Type:Individual
Prefix:DR
First Name:JALENA
Middle Name:J
Last Name:BOWN
Suffix:
Gender:F
Credentials:PH60473403
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1203 S 40TH AVE APT 4
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98908-3972
Mailing Address - Country:US
Mailing Address - Phone:509-575-8036
Mailing Address - Fax:509-575-8700
Practice Address - Street 1:202 N DIVISION ST STE 401
Practice Address - Street 2:
Practice Address - City:AUBURN
Practice Address - State:WA
Practice Address - Zip Code:98001-4939
Practice Address - Country:US
Practice Address - Phone:253-545-2258
Practice Address - Fax:253-804-2871
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-21
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60473403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist