Provider Demographics
NPI:1144284779
Name:BRUMBLAY-DAILEY, JENNIFER NMI (RPH)
Entity type:Individual
Prefix:MS
First Name:JENNIFER
Middle Name:NMI
Last Name:BRUMBLAY-DAILEY
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1107 W 13TH AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-3909
Mailing Address - Country:US
Mailing Address - Phone:509-455-6754
Mailing Address - Fax:509-455-4479
Practice Address - Street 1:508 W 6TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2770
Practice Address - Country:US
Practice Address - Phone:509-455-9345
Practice Address - Fax:509-455-4479
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA14389183500000X
IDP4767183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist