Individual
PETE A. JACQUES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2202 S CEDAR ST, STE. #310, TACOMA, WA 98405-2318
(253) 272-5127
(253) 404-0506
Mailing address
PO BOX 1241, TACOMA, WA 98401-1241
(253) 272-5127
(253) 404-0506
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10001731
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PA10001731
WA LICENSE
WA
Enumeration date
02/13/2006
Last updated
06/15/2009
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