Healthcare Provider Details

I. General information

NPI: 1790049179
Provider Name (Legal Business Name): JENNIFER L SCHURMAN PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/29/2012
Last Update Date: 02/21/2020
Certification Date: 02/21/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 7TH AVE
LONGVIEW WA
98632-3166
US

IV. Provider business mailing address

41011 NE 12TH AVE
WOODLAND WA
98674-3217
US

V. Phone/Fax

Practice location:
  • Phone: 360-575-4850
  • Fax: 360-636-6249
Mailing address:
  • Phone: 360-225-9460
  • Fax: 360-225-9460

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00070250
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: