Provider Demographics
NPI:1750459780
Name:ZACHERY, JASMYN KIANNA (PHARMD, RPH)
Entity Type:Individual
Prefix:DR
First Name:JASMYN
Middle Name:KIANNA
Last Name:ZACHERY
Suffix:
Gender:F
Credentials:PHARMD, RPH
Other - Prefix:DR
Other - First Name:JASMYN
Other - Middle Name:KIANNA
Other - Last Name:ZACKERY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHARMD, RPH
Mailing Address - Street 1:744 SW CEDAR HILL DR
Mailing Address - Street 2:
Mailing Address - City:MADRAS
Mailing Address - State:OR
Mailing Address - Zip Code:97741-9329
Mailing Address - Country:US
Mailing Address - Phone:678-471-0234
Mailing Address - Fax:
Practice Address - Street 1:744 SW CEDAR HILL DR
Practice Address - Street 2:
Practice Address - City:MADRAS
Practice Address - State:OR
Practice Address - Zip Code:97741-9329
Practice Address - Country:US
Practice Address - Phone:678-471-0234
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC1835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy