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Individual

JACOB ROYAL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
NP-C

Contact information

Practice address
5015 LUCENA DR, PASCO, WA 99301-8370
(509) 380-7378
Mailing address
5015 LUCENA DR, PASCO, WA 99301-8370
(509) 380-7378
(509) 222-1289

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60570569
WA
363LF0000X
Family Nurse Practitioner
R41002
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
AP60570569
WA
Enumeration date
09/25/2014
Last updated
07/20/2023
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