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Individual

DR. JACOB HOWARD BAUER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
304 W BAY DR NW, STE 301, OLYMPIA, WA 98502-4958
(360) 413-8760
Mailing address
304 W BAY DR NW, STE 301, OLYMPIA, WA 98502-4958
(360) 413-8760

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
MD 60075013
WA
207N00000X
Dermatology Physician
MD12612
RI
207ND0101X
MOHS-Micrographic Surgery Physician
Primary
MD 60075013
WA
207ND0101X
MOHS-Micrographic Surgery Physician
MD12612
RI

Other

Enumeration date
04/08/2008
Last updated
10/22/2013
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