Healthcare Provider Details

I. General information

NPI: 1407750607
Provider Name (Legal Business Name): JACKELINE JOHANNA CHAVEZ PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/03/2026
Last Update Date: 10/03/2026
Certification Date: 10/02/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2271 BEL PRE RD
SILVER SPRING MD
20906-2204
US

IV. Provider business mailing address

2271 BEL PRE RD
SILVER SPRING MD
20906-2204
US

V. Phone/Fax

Practice location:
  • Phone: 301-598-6617
  • Fax:
Mailing address:
  • Phone: 301-598-6617
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License Number31223
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: