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Individual
JACOB MYLES MCLEOD
Active
Individual
JACOB MYLES MCLEOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
PO60466892
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0304956
WASHINGTON L&I
WA
05
—
1083909329
—
OR
05
—
1083909329
—
WA
Enumeration date
06/15/2011
Last updated
12/31/2015
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