DR. JACK RONALD TACKER


Address: 19160 Front St Ne, Poulsbo, WA 98370
Phone: 3607797500

DR. JACK RONALD TACKER (NPI# 1336379403) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1336379403
Entity Type Individual
Full Name DR. JACK RONALD TACKER
Credential M.D.
Practice Address 19160 Front St Ne
Poulsbo
WA 98370
Mailing Address Po Box 127
Poulsbo
WA 98370-0127
Practice Telephone 3607797500
Practice Fax Number 3606260600
Mailing Telephone 3607797500
Mailing Fax Number 2532882203
Enumeration Date 2009-07-22
Last Update Date 2013-06-05
Gender Code M
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 208D00000X General Practice MD00028053 WA Allopathic & Osteopathic Physicians

Office Location

Street Address 19160 FRONT ST NE
City POULSBO
State WA
Zip Code 98370

Providers in the same location

NPI Name Taxonomy Address Enumeration
1710988753 Martha and Mary Health Services Skilled Nursing Facility 19160 Front St Ne, Poulsbo, WA 98370-0127 2005-08-01
1609351139 Brittany Leeann Hedin Occupational Therapy Assistant 19160 Front St Ne, Poulsbo, WA 98370 2018-10-01
1699269381 Alicia Amy Williams Physical Therapy Assistant 19160 Front St Ne, Poulsbo, WA 98370 2018-06-18
1215461025 Lisa Patureau Occupational Therapy Assistant 19160 Front St Ne, Poulsbo, WA 98370 2017-04-18
1871869313 Alaire Call Lowe Speech-Language Pathologist 19160 Front St Ne, Poulsbo, WA 98370 2012-03-29

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1790324010 Francie Corinn Edens Massage Therapist 225 Nw Lindvig Way Suite# 6, Poulsbo, WA 98370 2020-01-03
1972155679 Marcela Serocki Massage Therapist 18657 Wa-305, Suite 4, Poulsbo, WA 98370 2019-07-12
1508425943 Ryan Brinton Physical Therapist Kitsap Physical Therapy and Sports Clinics, 19319 7th Ave Ne Ste 108, Poulsbo, WA 98370 2019-06-10
1598220816 Naomi Whitney Orong Massage Therapist 19068 Nw Jenson Way, Suite 4b, Poulsbo, WA 98370 2019-02-01
1043774953 Maryanne Phillips Bellman Physical Therapist 442 Viewmont Ave, Poulsbo, WA 98370 2019-01-24
1285102293 Andrea Sander Registered Nurse 19883 12th Ave Ne, Poulsbo, WA 98370 2018-11-07
1376038281 Sharon Renay Christor Nurse Practitioner 19160 Front St. Ne, Poulsbo, WA 98370 2018-06-25
1700304334 Samantha Przybylek Gavinski Nurse Practitioner 19500 10th Ave Ne Suite 100, Poulsbo, WA 98370 2017-09-04
1285164327 Johanna Taylor Behavior Technician 21786 Windmill Loop Nw, Poulsbo, WA 98370 2017-06-12
1568990554 Eva Geurtsen Physical Therapy Assistant 19160 Front St, Poulsbo, WA 98370 2017-06-02
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Taxonomy Information

Taxonomy Code 208D00000X
Grouping Allopathic & Osteopathic Physicians
Classification General Practice

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1902017510 Ruth Urand General Practice 278 Ne Moe St, Poulsbo, WA 98370-7347 2007-05-25
1922030444 Heritage Health Center Inc General Practice 20696 Bond Rd Ne, Suite 110, Poulsbo, WA 98370 2006-07-07

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1063971703 Source Northwest Integrative Medicine General Practice 7206 267th St Nw Ste 102, Stanwood, WA 98292-6269 2019-03-12
1255896601 Emily Christine Buck General Practice 940 Fitzsimmons Dr, Tacoma, WA 98431-0001 2019-02-08
1740755651 Alyssa Ann Yruegas General Practice 2108 W Spruce St, Moses Lake, WA 98837-2853 2018-10-06
1306321237 Rainier Springs Physician Group, LLC General Practice 2805 Ne 129th Street, Vancouver, WA 98686 2018-09-26
1962916437 Parkview Medical Group Inc General Practice 615 S Division St Ste A, Moses Lake, WA 98837-3800 2017-11-20
1790212496 Thien Thanh Ho General Practice 12307 Douglas Rd, Yakima, WA 98908-9129 2017-05-12
1285173625 Regenerative Medicine Institute, Pllc General Practice 731 N Stanley St, Medical Lake, WA 99022-8940 2017-02-17
1457708430 James Bailey General Practice 9040 Jackson Ave Tripler Army Medical Center, Tacoma, WA 98431-5001 2016-05-19
1740635887 Peter Chulhi Kang General Practice 1425 Spring St Apt 802, Seattle, WA 98104-1635 2016-04-26
1831551084 Anna Hackenmiller General Practice 1657 S Nettleton Ln, Spokane, WA 99224-6108 2016-03-27
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Competitor

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City POULSBO
Zip Code 98370

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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