Individual
JANUARY-JILL OGOY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(844) 364-2778
(253) 627-7880
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(844) 364-2778
(253) 627-7880
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
0110003606
VA
363A00000X
Physician Assistant
Primary
PA60989471
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2143286
—
WA
Enumeration date
06/27/2011
Last updated
12/08/2020
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