Individual
JERRY S. NNANABU
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
(253) 596-3300
Mailing address
209 MARTIN LUTHER KING JR WAY, TACOMA, WA 98405-4265
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
125066987
IL
207RC0000X
Cardiovascular Disease Physician
Primary
60837284
WA
207UN0901X
Nuclear Cardiology Physician
60837284
WA
Other
Enumeration date
06/12/2015
Last updated
07/14/2021
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