Individual
DR. JACK JOHN CALABRIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
5410B BARNES AVE NW, SEATTLE, WA 98107-3839
(206) 782-9530
(206) 782-0184
Mailing address
5410B BARNES AVE NW, SEATTLE, WA 98107-3839
(206) 782-9530
(206) 782-0184
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00000789
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1037274
—
WA
01
—
5881
LABOR & INDUSTRIES
WA
Enumeration date
11/21/2006
Last updated
07/08/2007
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