Provider Demographics
NPI:1457753212
Name:AAL, JON (RPH)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:
Last Name:AAL
Suffix:
Gender:M
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5726 MCLANE CREEK CT SW
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98512-2830
Mailing Address - Country:US
Mailing Address - Phone:360-943-9001
Mailing Address - Fax:
Practice Address - Street 1:5726 MCLANE CREEK CT SW
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98512-2830
Practice Address - Country:US
Practice Address - Phone:360-943-9001
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-23
Last Update Date:2014-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00011350183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist