Provider Demographics
NPI:1821318445
Name:JEFFERY, MICHELLE ANN (RPH, CIP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:ANN
Last Name:JEFFERY
Suffix:
Gender:F
Credentials:RPH, CIP
Other - Prefix:
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:OCHSNER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:11521 52ND AVE SE
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98208-9235
Mailing Address - Country:US
Mailing Address - Phone:425-357-1233
Mailing Address - Fax:
Practice Address - Street 1:802 134TH ST SW, BLDG C, STE 140
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98204
Practice Address - Country:US
Practice Address - Phone:800-607-6861
Practice Address - Fax:800-633-0334
Is Sole Proprietor?:No
Enumeration Date:2010-06-04
Last Update Date:2021-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH 00040980183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist