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General NPI Number Information
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NPI Number | 1336240605
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Entity Type | Individual
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Provider Name | JENNIFER MARIE MECCA PHARM.D.
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Gender | Female
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | VA PUGET SOUND, AMERICAN LAKE, PHARMACY 119 9600 VETERANS DRIVE
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City | TACOMA
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State | WA
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Zip | 98493-5000
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Country | US
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Telephone | 253-583-2314
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Fax |
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Provider Business Mailing Address
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Address Line | 506 MONTGOMERY ST
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City | STEILACOOM
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State | WA
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Zip | 98388
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Country | US
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Telephone | 253-589-0540
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PH00042837
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License Number State | WA
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