Individual
DR. LOREN S JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
427 S BERNARD ST, SPOKANE, WA 99204-2509
(509) 456-0107
(509) 747-2635
Mailing address
427 S BERNARD ST, SPOKANE, WA 99204-2509
(509) 456-0107
(509) 747-2635
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
60524950
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2042528
—
WA
Enumeration date
10/14/2009
Last updated
08/01/2024
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