Individual
DR. JACOB WALLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
10315 19TH AVE SE, SUITE 106, EVERETT, WA 98208-4268
(425) 338-5537
Mailing address
10315 19TH AVE SE, SUITE 106, EVERETT, WA 98208-4268
(425) 338-5537
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CH34455
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0203575
LABOR AND INDUSTIRES/WC
WA
Enumeration date
11/01/2006
Last updated
03/25/2016
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