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Individual

JEFFERY ALLEN TICHENOR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
PHARM.D.

Contact information

Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6692
Mailing address
2413 S I ST, TACOMA, WA 98405-3867
(269) 369-0937

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
5302034548
MI
183500000X
Pharmacist
Primary
PH00070885
WA

Other

Enumeration date
10/04/2007
Last updated
10/04/2007
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