Individual
JEFFREY WALLACE JANSEN
Active
Individual
JEFFREY WALLACE JANSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHARM.D.
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
RPH-0014882
OR
1835I0206X
Infectious Diseases Pharmacist
Primary
PHA-PHA-LIC-43413
MT
Other
Enumeration date
08/20/2015
Last updated
09/14/2023
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