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General NPI Number Information
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NPI Number | 1912698309
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Entity Type | Individual
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Provider Name | JESSICA LEIGH NEVAREZ PHARMD
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Gender | Female
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Dates
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Enumeration Date | 05/16/2023
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Last Update Date | 05/18/2023
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Provider Practice Location Address
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Address Line | 3030 NE WEIDLER ST
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City | PORTLAND
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State | OR
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Zip | 97232-1851
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Country | US
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Telephone | 503-280-1333
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Fax | 503-280-1327
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Provider Business Mailing Address
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Address Line | 3063 NE OVERLOOK DR APT 615
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City | HILLSBORO
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State | OR
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Zip | 97124-7195
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Country | US
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Telephone | 503-750-2753
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Fax | 503-280-1327
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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 | 1835P0018X
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Taxonomy Name | Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
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License Number | RPH-0019483
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License Number State | OR
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