Diercks, Jacqueline June
Diercks, Jacqueline June is an sole proprietor health care provider with primary practice located at 4111 194Th St Sw , Lynnwood WA 98036-4604. She recently has 2 registered licenses in different health care specialties including Pharmacy Service Providers / Ambulatory Care, Pharmacy Service Providers / Pharmacist. Pharmacy Service Providers / Pharmacist is her primary health care specialty. Diercks, Jacqueline June can be contacted via phone (425) 835-5202.Contact Information
Primary practice address
4111 194Th St Sw
Lynnwood WA 98036-4604
Phone: (425) 835-5202
Fax: (425) 835-5203
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Pharmacy Service Providers / Ambulatory Care | 1835P2201X | PH00068563 | Washington |
| Pharmacy Service Providers / Pharmacist | 183500000X | PH00068563 | Washington |
Profile Details
| NPI number | 1770878076 |
|---|---|
| LBN Legal business name | Diercks, Jacqueline June |
| Credentials | PHARM.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 14th, 2011 |
| Last updated | Aug 13th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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