Individual
JESSICA MARIE OTERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
4800 SAND POINT WAY NE, M/S R-3409, SEATTLE, WA 98105-3901
(206) 987-6262
(206) 987-6337
Mailing address
M/S R-3409 PO BOX 5371, SEATTLE, WA 98105
(206) 987-6262
(206) 987-6337
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
PH00069947
WA
183500000X
Pharmacist
PHA-16103
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PH00069947
WASHINGTON STATE PHARMACIST LICENSE
WA
01
—
PHA-16103
COLORDADO STATE PHARMACIST
CO
Enumeration date
05/19/2010
Last updated
05/19/2010
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