Jack Ronald Tacker, M.D.
General Practice Physician · Poulsbo, WA
Practice location
19160 Front St NEPoulsbo, WA 98370
- Phone
- (360) 779-7500
- Fax
- (360) 626-0600
NPI record
- NPI
- 1336379403
- Entity type
- Individual (Type 1)
- Enumeration date
- July 22, 2009
- Last updated
- June 5, 2013
- Sole proprietor
- Yes
Specialties & taxonomy codes
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Physician Primary | 208D00000X |
MD00028053 | WA |
Mailing address
PO Box 127Poulsbo, WA 98370-0127
- Phone
- (360) 779-7500
- Fax
- (253) 288-2203
About Dr. Tacker
Jack Ronald Tacker, M.D. is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Physician (code 208D00000X). The practice location is 19160 Front St NE, Poulsbo, WA 98370. The NPI number 1336379403 was assigned on July 22, 2009 and the record was last updated on June 5, 2013.
Dr. Tacker lists a license in the registry: #MD00028053 (WA) for General Practice Physician. License numbers are self-reported to NPPES; verify them with the state licensing board.
Frequently asked questions
What is the NPI number of Jack Ronald Tacker, M.D.?
The NPI number is 1336379403.
What is the phone number of Dr. Tacker?
The phone number listed for the practice location is (360) 779-7500.
Where is Dr. Tacker located?
19160 Front St NE, Poulsbo, WA 98370.
What is the taxonomy code for Dr. Tacker?
The primary taxonomy code is 208D00000X – General Practice Physician.
Is this information correct?
All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.
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