NPI 1134571755

Miguel Jacome, EFDAASSISTANT

Practitioner Dental Assistant Tacoma, WA

Practice location

Address: N Division St Bldg 2103, Tacoma, WA 98431-0001
Phone: (253) 966-7814
Mailing address: 19710 13th Avenue CT E, Spanaway, WA 98387-8046

Registered specialties

Dental Assistant Primary

Dental Providers Taxonomy 126800000X

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Registry record

NPI: 1134571755
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Jul 2016
Record last updated: 7 Jul 2016

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.