JEFFREY BRUCE WALL (NPI# 1275808636) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1275808636 |
| Entity Type | Individual |
| Full Name | JEFFREY BRUCE WALL |
| Credential | PHARMACIST |
| Practice Address |
33702 21st Ave Sw Federal Way WA 98023-7762 |
| Mailing Address |
30201 18th Ave Sw Federal Way WA 98023-3443 |
| Practice Telephone | 2539520133 |
| Mailing Telephone | 2536534624 |
| Enumeration Date | 2012-03-19 |
| Last Update Date | 2012-03-19 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 183500000X | Pharmacist | 00010797 | WA | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447288808 | Jeffrey A Wall | Family Medicine | 190 Stetson Rd, Auburn, ME 04210-7813 | 2006-06-28 |
| 1487628921 | Jeffrey W Wall | Obstetrics & Gynecology | 2301 Holmes St, Kansas City, MO 64108-2640 | 2006-02-13 |
| Street Address |
33702 21ST AVE SW |
| City | FEDERAL WAY |
| State | WA |
| Zip Code | 98023-7762 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942246483 | Fred Meyer Stores Inc | Pharmacy | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2006-06-22 |
| 1861922064 | Kristin Phuong-thao Le | Pharmacist | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2017-06-20 |
| 1063953982 | Peter Chin | Pharmacist | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2017-03-10 |
| 1831631738 | Soyoung Park | Pharmacist | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2016-11-08 |
| 1285188177 | Nick Sathya-thon Malai | Pharmacist | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2016-08-08 |
| 1902274061 | Pilita Gruber | Pharmacist | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2015-09-07 |
| 1043579592 | Zarna Gandhi | Pharmacist | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2012-05-03 |
| 1851659973 | Catherine Stevens | Pharmacist | 33702 21st Ave Sw, 701111, Federal Way, WA 98023 | 2012-04-26 |
| 1629343785 | Michael Liao | Pharmacist | 33702 21st Ave Sw, Federal Way, WA 98023-7762 | 2012-03-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1366093908 | Marlene Dawson | Technician | 33228 37th Place S.w., Federal Way, WA 98023 | 2019-09-25 |
| 1861994956 | Allen Abelgas Schimke | Registered Nurse | 1300 Sw Campus Drive Unit 38-4, Federal Way, WA 98023 | 2018-03-05 |
| 1568981298 | Hau Thi-le Vu | Dental Hygienist | 31174 2nd Pl Sw, Federal Way, WA 98023 | 2017-09-13 |
| 1700309416 | Jennifer Lynn Cha | Physician Assistant | 820 Sw 341st St., Federal Way, WA 98023 | 2017-07-25 |
| 1205373958 | Irina Poiata | Reflexologist | 1900 Sw Campus De Apt 15- 303, Federal Way, WA 98023 | 2017-01-19 |
| 1194275800 | Cynthia Marcellus | Counselor | 4523 Federal Ave, Everett, WA 98023 | 2016-10-05 |
| 1023441383 | Samantha Anne Larson | Pharmacist | 1300 Sw Campus Drive Apt 4-4, Federal Way, WA 98023 | 2013-08-09 |
| 1609149079 | Stacey Lee Beilke | Massage Therapist | 215 Sw 319th Lane, Apt L204, Federal Way, WA 98023 | 2012-02-16 |
| 1336456110 | Elweda Silva | General Acute Care Hospital | 31054 1st Pl Sw, Federal Way, WA 98023 | 2010-09-01 |
| 1114168739 | Aleksandra Starikov | Mechanotherapist | 34425 16th Ave Sw, Federal Way, WA 98023 | 2009-03-11 |
| Find all providers in zip 98023 | ||||
| Taxonomy Code | 183500000X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| An individual licensed by the appropriate state regulatory agency to engage in the practice of pharmacy. The practice of pharmacy includes, but is not limited to, assessment, interpretation, evaluation, and implementation, initiation, monitoring or modification of medication and or medical orders; the compounding or dispensing of medication and or medical orders; participation in drug and device procurement, storage, and selection; drug administration; drug regimen reviews; drug or drug-related research; provision of patient education and the provision of those acts or services necessary to provide medication therapy management services in all areas of patient care. |
| Notes: Source: Adapted from National Association of Boards of Pharmacy Model State Pharmacy Act, Article 1, Section 104. [1/1/2006: definition modified, source modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023650546 | Teshale Mekonnen Semre | Pharmacist | 834 Sw 361st St, Federal Way, WA 98023-7290 | 2019-10-16 |
| 1174976054 | Joshua Hevener | Pharmacist | 34617 11th Pl S Ste 301, Federal Way, WA 98003-8706 | 2016-07-15 |
| 1659742823 | Nicholas Vu | Pharmacist | 36835 4th Ave Sw, Federal Way, WA 98023-7343 | 2015-10-14 |
| 1366811531 | Yongjoo Shim | Pharmacist | 31840 Pacific Hwy S Ste A2, Federal Way, WA 98003-5450 | 2015-09-17 |
| 1306213400 | Eun Kim | Pharmacist | 125 Sw Campus Dr Apt 23-203, Federal Way, WA 98023-8331 | 2015-08-25 |
| 1023441383 | Samantha Anne Larson | Pharmacist | 1300 Sw Campus Drive Apt 4-4, Federal Way, WA 98023 | 2013-08-09 |
| 1639418148 | Dennis W Klemmer | Pharmacist | 3900 Sw 321st St, Federal Way, WA 98023-2412 | 2013-02-04 |
| 1639422066 | Daleen Angeline Lyle | Pharmacist | 33520 21st Ave Sw, Federal Way, WA 98023-2874 | 2012-10-23 |
| 1184971012 | Puey Chow | Pharmacist | 37524 27th Pl S, Federal Way, WA 98003-7516 | 2012-08-09 |
| 1902191646 | Katherine E Wolf | Pharmacist | 32129 Weyerhaeuser Way S Ste 201, Federal Way, WA 98001-9802 | 2011-06-10 |
| Find all providers in FEDERAL WAY | ||||
| City | FEDERAL WAY |
| Zip Code | 98023 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.