Healthcare Provider Details

I. General information

NPI: 1790230852
Provider Name (Legal Business Name): JEFFREY NYE PHARM.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/18/2016
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1717 13TH ST STE 300
EVERETT WA
98201-1621
US

IV. Provider business mailing address

7600 EVERGREEN WAY
EVERETT WA
98203-6421
US

V. Phone/Fax

Practice location:
  • Phone: 425-297-5560
  • Fax: 425-297-5561
Mailing address:
  • Phone: 206-860-5414
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P2201X
TaxonomyAmbulatory Care Pharmacist
License NumberPH60664408
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: