Individual
MR. WILLIAM CHARLES JACOBS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
FNP
Contact information
Practice address
816 8TH ST NW, PUYALLUP, WA 98371-4129
(253) 770-9839
Mailing address
816 8TH ST NW, PUYALLUP, WA 98371-4129
(253) 770-9839
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN00086779
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30002294
WA
Other
Enumeration date
10/16/2006
Last updated
08/26/2016
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