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NPI Code Detail

MEDICARE: MISS JACQUELINE DAYLE WATERS PHARMD

MEDICARE: MISS JACQUELINE DAYLE WATERS PHARMD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1183500000XPharmacistRPH-0018868OR

General Provider Information

NPI Number : 1144504887
Entity Type Code : Individual
Provider Name (Legal Business Name) : MISS JACQUELINE DAYLE WATERS PHARMD
Provider Business Mailing Address
First Line : 2251 E HANCOCK ST STE 100
Second Line :
City : NEWBERG
State : OR
Zip : 97132-2145
Country : US
Telephone Number : 971-281-3060
Fax Number : 971-281-3061
Provider Business Practice Location Address
First Line : 2280 N LAS VEGAS BLVD
Second Line :
City : NORTH LAS VEGAS
State : NV
Zip : 89030-5803
Country : US
Telephone Number : 702-649-1415
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2011
Last Update Date : 11/06/2025

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Directions to “ MISS JACQUELINE DAYLE WATERS PHARMD” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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