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Individual

JAKOB O CAMP

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
101 W 8TH AVE, SPOKANE, WA 99204-2307
(509) 474-4818
(509) 462-4086
Mailing address
910 N WASHINGTON ST, STE 209, SPOKANE, WA 99201-2202

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00045912
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
8448474
WA MEDICAID
WA
01
GAB32999
MEDICARE GROUP
WA
Enumeration date
07/04/2006
Last updated
01/20/2009
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