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Individual

MS. DENISE JOANN JACKMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RPH

Contact information

Practice address
1410 W 27TH AVE, KENNEWICK, WA 99337-3701
(509) 585-0846
(509) 585-0847
Mailing address
2011 W 35TH AVE, KENNEWICK, WA 99337-3720
(509) 582-2753
(509) 585-0847

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00010508
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
PH00010508
PHARMACY LICENSE
WA
Enumeration date
09/27/2006
Last updated
07/08/2007
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