Provider Demographics
NPI:1053546721
Name:LESSIAK, JENNIFER SUZANNE (PHARMD)
Entity type:Individual
Prefix:
First Name:JENNIFER
Middle Name:SUZANNE
Last Name:LESSIAK
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1504 S VIRGINIA RD
Mailing Address - Street 2:
Mailing Address - City:SPOKANE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:99216-2348
Mailing Address - Country:US
Mailing Address - Phone:509-869-7481
Mailing Address - Fax:
Practice Address - Street 1:400 S THOR ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-5075
Practice Address - Country:US
Practice Address - Phone:509-532-4033
Practice Address - Fax:509-532-4027
Is Sole Proprietor?:No
Enumeration Date:2009-05-23
Last Update Date:2010-10-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH00056403183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist