Individual
MR. JON A NIELSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 575-4841
Mailing address
1230 7TH AVE, LONGVIEW, WA 98632-3166
(360) 575-4841
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
6302
MT
183500000X
Pharmacist
Primary
PH60163314
WA
183500000X
Pharmacist
RPH-0013019
OR
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
RPH-0013019
OR
1835P2201X
Ambulatory Care Pharmacist
PH60163314
WA
Other
Enumeration date
05/12/2010
Last updated
12/18/2015
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