Provider Demographics
NPI:1689995326
Name:NARRA, JAYAPAL REDDY (MPHARM)
Entity Type:Individual
Prefix:MR
First Name:JAYAPAL
Middle Name:REDDY
Last Name:NARRA
Suffix:
Gender:M
Credentials:MPHARM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20285 111TH WAY SE
Mailing Address - Street 2:
Mailing Address - City:KENT
Mailing Address - State:WA
Mailing Address - Zip Code:98031-5565
Mailing Address - Country:US
Mailing Address - Phone:253-981-4905
Mailing Address - Fax:
Practice Address - Street 1:3840 BRIDGEPORT WAY W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-4416
Practice Address - Country:US
Practice Address - Phone:253-564-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-17
Last Update Date:2010-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 60021390183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist