Individual
MR. MIGUEL JACOME JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
EFDA ASSISTANT
Contact information
Practice address
N DIVISION ST BLDG 2103, TACOMA, WA 98431-0001
(253) 966-7814
Mailing address
19710 13TH AVENUE CT E, SPANAWAY, WA 98387-8046
(208) 818-6238
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
—
—
Other
Enumeration date
07/07/2016
Last updated
07/07/2016
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