Provider Demographics
NPI:1790514099
Name:JENKINS, BRENNAN TURLEY (PHARMD)
Entity type:Individual
Prefix:
First Name:BRENNAN
Middle Name:TURLEY
Last Name:JENKINS
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 1:2263 SE SAGE BROOKE RD
Mailing Address - Street 2:
Mailing Address - City:EAST WENATCHEE
Mailing Address - State:WA
Mailing Address - Zip Code:98802-8039
Mailing Address - Country:US
Mailing Address - Phone:801-707-6645
Mailing Address - Fax:
Practice Address - Street 1:375 HIGHLINE DR
Practice Address - Street 2:
Practice Address - City:EAST WENATCHEE
Practice Address - State:WA
Practice Address - Zip Code:98802-5344
Practice Address - Country:US
Practice Address - Phone:509-886-0754
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-07-26
Last Update Date:2024-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTPHA-PHA-LIC-107459183500000X
WAPH61575628183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist