NPI 1275851289

Jon R Tacey, LMP

Practitioner Contractor Port Orchard, WA

Practice location

Address: 3100 SE Mile Hill Dr STE a, Port Orchard, WA 98366-2962
Phone: (360) 895-4844
Fax: (360) 895-4834

Registered specialties

Contractor Primary

Other Service Providers Taxonomy 171W00000X Licence MA60018860 (WA)

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Registry record

NPI: 1275851289
Entity type: Individual
Sex (as registered): Male
NPI issued: 14 May 2010
Record last updated: 14 May 2010

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.