Individual
MRS. JACQUELINE JUNE DIERCKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHARM.D.
Contact information
Practice address
4111 194TH ST SW, LYNNWOOD, WA 98036-4604
(425) 835-5202
(425) 835-5203
Mailing address
4111 194TH ST SW, LYNNWOOD, WA 98036-4604
(425) 835-5202
(425) 835-5203
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00068563
WA
1835P2201X
Ambulatory Care Pharmacist
PH00068563
WA
Other
Enumeration date
06/14/2011
Last updated
08/13/2019
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