Individual
JAY G SACKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1310 S UNION AVE, #B1, TACOMA, WA 98405-1907
(253) 475-2601
(253) 572-8224
Mailing address
1310 S UNION AVE, #B1, TACOMA, WA 98405-1907
(253) 475-2601
(253) 572-8224
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14616
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0016337
L&I
WA
05
—
1306307
—
WA
01
—
757081059
RAILROAD MEDICARE
WA
01
—
SA3808
REGENCE
WA
Enumeration date
10/14/2006
Last updated
05/19/2010
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