Individual
JACOB LIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2245 S 19TH ST, TACOMA, WA 98405-2945
(253) 572-1444
Mailing address
2245 S 19TH ST, TACOMA, WA 98405-2945
(253) 572-1444
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
D97811
MD
207W00000X
Ophthalmology Physician
MD473519
PA
207W00000X
Ophthalmology Physician
Primary
MD61505824
WA
Other
Enumeration date
01/26/2015
Last updated
08/01/2024
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