Individual
JACOB NETTLETON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
26401 PACIFIC HWY S STE 101, DES MOINES, WA 98198-9247
(206) 870-3590
(206) 824-1670
Mailing address
955 POWELL AVE SW, RENTON, WA 98057-2908
(425) 277-1311
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD60775862
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/10/2014
Last updated
01/13/2025
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