Provider Demographics
NPI:1295002962
Name:HAMILTON, JACK MILLER JR (PHARMD, MBA)
Entity type:Individual
Prefix:DR
First Name:JACK
Middle Name:MILLER
Last Name:HAMILTON
Suffix:JR
Gender:M
Credentials:PHARMD, MBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5921 INDIAN TRL NE
Mailing Address - Street 2:
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98422-4212
Mailing Address - Country:US
Mailing Address - Phone:773-710-8290
Mailing Address - Fax:
Practice Address - Street 1:5921 INDIAN TRL NE
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98422-4212
Practice Address - Country:US
Practice Address - Phone:773-710-8290
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-23
Last Update Date:2025-05-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA61133183500000X
WAPH60680447183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes183500000XPharmacy Service ProvidersPharmacist