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NPI Code Detail

MEDICARE: JESSICA OFTEBRO PHARMD

MEDICARE: JESSICA OFTEBRO 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
1101YM0800XMental Health CounselorMC61472593WA
2183500000XPharmacistPH60033238WA

General Provider Information

NPI Number : 1326630948
Entity Type Code : Individual
Provider Name (Legal Business Name) : JESSICA OFTEBRO PHARMD
Provider Business Mailing Address
First Line : 10116 NE 8TH ST
Second Line :
City : BELLEVUE
State : WA
Zip : 98004-4148
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 417 BROADWAY E
Second Line :
City : SEATTLE
State : WA
Zip : 98102-5009
Country : US
Telephone Number : 206-328-6920
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2021
Last Update Date : 05/31/2024

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