Provider Demographics
NPI:1760782254
Name:RAWLINGS, JARED JORDAN (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:JORDAN
Last Name:RAWLINGS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47150 WILDBERRY CT
Mailing Address - Street 2:
Mailing Address - City:KENAI
Mailing Address - State:AK
Mailing Address - Zip Code:99611-5946
Mailing Address - Country:US
Mailing Address - Phone:907-953-9115
Mailing Address - Fax:
Practice Address - Street 1:44428 STERLING HWY
Practice Address - Street 2:
Practice Address - City:SOLDOTNA
Practice Address - State:AK
Practice Address - Zip Code:99669-8033
Practice Address - Country:US
Practice Address - Phone:907-714-5460
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK1585183500000X
WY3060183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist