Provider Demographics
NPI:1265706915
Name:DANIELS, JENNIFER H (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:H
Last Name:DANIELS
Suffix:
Gender:F
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:PO BOX 5127
Mailing Address - Street 2:
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98206-5127
Mailing Address - Country:US
Mailing Address - Phone:425-259-1180
Mailing Address - Fax:
Practice Address - Street 1:1800 41ST ST
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98203-2355
Practice Address - Country:US
Practice Address - Phone:425-259-1180
Practice Address - Fax:459-259-1172
Is Sole Proprietor?:No
Enumeration Date:2012-02-28
Last Update Date:2020-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH602487031835P0018X, 183500000X
AZS0121791835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
No1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist