Healthcare Provider Details

I. General information

NPI: 1023450921
Provider Name (Legal Business Name): JESSICA LYNN WEST PHARMD., RPH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/22/2013
Last Update Date: 01/05/2024
Certification Date: 01/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 W 15TH ST STE 203
VANCOUVER WA
98660-2911
US

IV. Provider business mailing address

2612 NE 158TH ST
VANCOUVER WA
98686-1564
US

V. Phone/Fax

Practice location:
  • Phone: 360-524-7182
  • Fax: 360-524-7183
Mailing address:
  • Phone: 360-852-5519
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH-0013618
License Number StateOR
# 2
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH-0013618
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: