Provider Demographics
NPI:1912698309
Name:NEVAREZ, JESSICA LEIGH (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:JESSICA
Middle Name:LEIGH
Last Name:NEVAREZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JESSICA
Other - Middle Name:LEIGH
Other - Last Name:LEE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3063 NE OVERLOOK DR APT 615
Mailing Address - Street 2:
Mailing Address - City:HILLSBORO
Mailing Address - State:OR
Mailing Address - Zip Code:97124-7195
Mailing Address - Country:US
Mailing Address - Phone:503-750-2753
Mailing Address - Fax:503-280-1327
Practice Address - Street 1:3030 NE WEIDLER ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97232-1851
Practice Address - Country:US
Practice Address - Phone:503-280-1333
Practice Address - Fax:503-280-1327
Is Sole Proprietor?:No
Enumeration Date:2023-05-16
Last Update Date:2023-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-00194831835P0018X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P0018XPharmacy Service ProvidersPharmacistPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist