JACK R. TACKER M.D. – NPI #1336379403
General Practice
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.
JACK TACKER is a physician located in POULSBO, WA. NPPES has assigned the NPI number 1336379403 to JACK TACKER on July 22, 2009. It is a Type-1 NPI, indicating this NPI number is associated with an individual. The primary taxonomy selected by this provider is 208D00000X from the Health Care Provider Taxonomy code set, which is classified as General Practice.
The NPI profile was previously updated about 13 years ago on Jun 05, 2013. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for JACK TACKER below.
NPI Profile for
JACK R. TACKER
(about 17 years ago)
POULSBO, WA 98370 Phone: (360) 779-7500 Fax: (360) 626-0600
POULSBO, WA 98370-0127 Phone: (360) 779-7500 Fax: (253) 288-2203
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 208D00000X - General Practice (Primary) |
WA | MD00028053 |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.