Individual
JACK W ROMANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
300 W PAPERMILL RUN UNIT 311, KIMBERLY, WI 54136-5507
(206) 940-0962
Mailing address
300 W PAPERMILL RUN UNIT 311, KIMBERLY, WI 54136-5507
(206) 940-0962
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
PA10002119
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G8864515
MEDICARE PTAN
WA
Enumeration date
03/09/2007
Last updated
05/01/2026
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