Provider Demographics
NPI:1518022474
Name:LASHBROOK, JASON M (MS, PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JASON
Middle Name:M
Last Name:LASHBROOK
Suffix:
Gender:M
Credentials:MS, PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5800 E RIO VERDE VISTA DR
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85750-1973
Mailing Address - Country:US
Mailing Address - Phone:805-400-8047
Mailing Address - Fax:
Practice Address - Street 1:5800 E RIO VERDE VISTA DR
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85750-1973
Practice Address - Country:US
Practice Address - Phone:805-400-8047
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2016-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ133201835P1300X
CA706851835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1300XPharmacy Service ProvidersPharmacistPsychiatric
No1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ13320OtherAZ STATE BOARD OF PHARM
CA70685OtherCALIFORNIA STATE BOARD OF PHARMACY