Healthcare Provider Details

I. General information

NPI: 1962649152
Provider Name (Legal Business Name): JENNIFER LYNN PAK PHARM.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENNIFER FREEBURG PHARMD

II. Dates (important events)

Enumeration Date: 01/09/2009
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18024 94TH AVE NE
BOTHELL WA
98011-3314
US

IV. Provider business mailing address

18024 94TH AVE NE
BOTHELL WA
98011-3314
US

V. Phone/Fax

Practice location:
  • Phone: 206-817-3897
  • Fax:
Mailing address:
  • Phone: 206-817-3897
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00064179
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: