Healthcare Provider Details

I. General information

NPI: 1538459615
Provider Name (Legal Business Name): JANENE CHERIE JONES RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2011
Last Update Date: 04/11/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1940 E 1ST ST #110
PORT ANGELES WA
98362-4990
US

IV. Provider business mailing address

1940 E 1ST ST #110
PORT ANGELES WA
98362-4990
US

V. Phone/Fax

Practice location:
  • Phone: 360-457-3456
  • Fax: 360-457-5293
Mailing address:
  • Phone: 360-457-3456
  • Fax: 360-457-5293

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPH00011721
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: