Provider Demographics
NPI:1750681474
Name:NEWCOMER, JENNIFER K (RPH)
Entity Type:Individual
Prefix:
First Name:JENNIFER
Middle Name:K
Last Name:NEWCOMER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:JENNIFER
Other - Middle Name:K
Other - Last Name:MURPHY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RPH
Mailing Address - Street 1:326 S STILLAGUAMISH AVE
Mailing Address - Street 2:
Mailing Address - City:ARLINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98223-1652
Mailing Address - Country:US
Mailing Address - Phone:360-572-5454
Mailing Address - Fax:360-572-5455
Practice Address - Street 1:326 S STILLAGUAMISH AVE
Practice Address - Street 2:
Practice Address - City:ARLINGTON
Practice Address - State:WA
Practice Address - Zip Code:98223-1652
Practice Address - Country:US
Practice Address - Phone:360-572-5454
Practice Address - Fax:360-572-5455
Is Sole Proprietor?:No
Enumeration Date:2010-10-27
Last Update Date:2017-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60089233183500000X
ORRPH-13554183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist