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Individual

DR. ANDREW STEVEN JACK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, MSC, FRCSC

Contact information

Practice address
550 17TH AVE STE 500, SEATTLE, WA 98122-5789
(206) 320-3782
Mailing address
1050 JAMES ST UNIT 512, SEATTLE, WA 98104-2787
(425) 961-2765

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
60814093
WA
207T00000X
Neurological Surgery Physician
Primary
A160007
CA

Other

Enumeration date
07/03/2018
Last updated
06/11/2019
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