Individual
JISHA JACOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-4101
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-4101
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
57661
TX
Other
Enumeration date
11/07/2016
Last updated
01/06/2023
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