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Individual

JENNIFER MICHELE TKACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
311 S L ST, TACOMA, WA 98405-3720
(253) 403-1420
Mailing address
311 S L ST, TACOMA, WA 98405-3720
(253) 403-1420

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
8684436-1205
UT
208000000X
Pediatrics Physician
Primary
MD60311888
WA
208000000X
Pediatrics Physician
R71570
AZ

Other

Enumeration date
11/19/2009
Last updated
09/18/2014
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