Provider Demographics
NPI:1518583475
Name:WALENTYNOWICZ, JESSICA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:
Last Name:WALENTYNOWICZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:
Other - Last Name:CHASE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:6356 WOODHAWK DR
Mailing Address - Street 2:
Mailing Address - City:MAYFIELD HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44124-4153
Mailing Address - Country:US
Mailing Address - Phone:216-571-0234
Mailing Address - Fax:
Practice Address - Street 1:5400 PEARL RD
Practice Address - Street 2:
Practice Address - City:PARMA
Practice Address - State:OH
Practice Address - Zip Code:44129-1545
Practice Address - Country:US
Practice Address - Phone:440-886-6233
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-17
Last Update Date:2020-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH03337619183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist