Provider Demographics
NPI:1841866142
Name:WOEHL, JILL RENEE (CPHT)
Entity type:Individual
Prefix:
First Name:JILL
Middle Name:RENEE
Last Name:WOEHL
Suffix:
Gender:F
Credentials:CPHT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6325 GREGORY ST W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-5844
Mailing Address - Country:US
Mailing Address - Phone:253-651-1430
Mailing Address - Fax:
Practice Address - Street 1:1912 N PEARL ST
Practice Address - Street 2:
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98406-2457
Practice Address - Country:US
Practice Address - Phone:253-879-0140
Practice Address - Fax:253-879-0273
Is Sole Proprietor?:No
Enumeration Date:2021-05-28
Last Update Date:2021-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVA00041668183700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183700000XPharmacy Service ProvidersPharmacy Technician