Provider Demographics
NPI:1518559830
Name:LEVER, JENNIFER (RPH)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:
Last Name:LEVER
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7728 213TH AVE SE
Mailing Address - Street 2:
Mailing Address - City:SNOHOMISH
Mailing Address - State:WA
Mailing Address - Zip Code:98290-7397
Mailing Address - Country:US
Mailing Address - Phone:425-876-1208
Mailing Address - Fax:
Practice Address - Street 1:1030 AVENUE D STE 2
Practice Address - Street 2:
Practice Address - City:SNOHOMISH
Practice Address - State:WA
Practice Address - Zip Code:98290-2086
Practice Address - Country:US
Practice Address - Phone:360-863-3009
Practice Address - Fax:844-375-4097
Is Sole Proprietor?:No
Enumeration Date:2021-02-08
Last Update Date:2021-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00017204183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WANONEOtherN/A