Individual
DR. DANIEL R. JACK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-2252
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-0001
(253) 968-2252
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
12229879-1205
UT
Other
Enumeration date
04/04/2017
Last updated
12/08/2023
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