Provider Demographics
NPI:1689124950
Name:MARQUIS, JILL (PHARMD)
Entity Type:Individual
Prefix:
First Name:JILL
Middle Name:
Last Name:MARQUIS
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 1:12606 NE 95TH ST
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98682-2398
Mailing Address - Country:US
Mailing Address - Phone:360-260-7156
Mailing Address - Fax:
Practice Address - Street 1:12606 NE 95TH ST
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98682-2398
Practice Address - Country:US
Practice Address - Phone:360-260-7156
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-10
Last Update Date:2016-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH 0014827183500000X
MTPHA-PHA-LIC 12211183500000X
WAPH60275090183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist