MEDICARE: JEFFREY DONALD WILLIAMS R.PH

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
1	183500000X	Pharmacist	1967	WY

General Provider Information

NPI Number	:	1568740876
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JEFFREY DONALD WILLIAMS R.PH

Provider Business Mailing Address
First Line	:	PO BOX 244
Second Line	:
City	:	WELCHES
State	:	OR
Zip	:	97067-0244
Country	:	US
Telephone Number	:	503-309-9722
Fax Number	:

Provider Business Practice Location Address
First Line	:	19401 40TH AVE W STE 330
Second Line	:
City	:	LYNNWOOD
State	:	WA
Zip	:	98036-5600
Country	:	US
Telephone Number	:	800-766-0122
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/03/2011
Last Update Date	:	08/03/2011

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