Individual
JACOB ADAM GRILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
809 W MAIN ST STE C, MONROE, WA 98272-2172
(206) 552-0882
Mailing address
809 W MAIN ST STE C, MONROE, WA 98272-2172
(206) 552-0882
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
—
—
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
09/16/2014
Last updated
06/12/2024
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