Individual
JACOBY J VAUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ARNP
Contact information
Practice address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 426-6344
Mailing address
1717 S J ST, TACOMA, WA 98405-4933
(253) 426-6341
(253) 426-6344
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP60302042
WA
363LF0000X
Family Nurse Practitioner
Primary
AP60302042
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0302713
STATE L&I
WA
Enumeration date
07/30/2012
Last updated
03/25/2016
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