Provider Demographics
NPI:1427622752
Name:WASHINGTON, JALESSA JONES (PHARMD)
Entity type:Individual
Prefix:
First Name:JALESSA
Middle Name:JONES
Last Name:WASHINGTON
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:JALESSA
Other - Middle Name:NICOLE
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:114 WYE OAK DR
Mailing Address - Street 2:
Mailing Address - City:TOWNSEND
Mailing Address - State:DE
Mailing Address - Zip Code:19734-9422
Mailing Address - Country:US
Mailing Address - Phone:404-644-2844
Mailing Address - Fax:
Practice Address - Street 1:5999 SUMMIT BRIDGE RD
Practice Address - Street 2:
Practice Address - City:TOWNSEND
Practice Address - State:DE
Practice Address - Zip Code:19734-9613
Practice Address - Country:US
Practice Address - Phone:302-696-1002
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-20
Last Update Date:2023-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX67667183500000X
DEA1-0015654183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist