Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363L00000X | Nurse Practitioner | AP30003324 | WA |
NPI | 1003923863 |
---|---|
Provider Name | Esther C Jakawich |
First Address | Gig Harbor, WA 98332-8738 |
Second Address | Gig Harbor, WA 98332-8738 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 25/08/2006 |
Last Update Date | 14/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1392208 | (05) | WA |
E22916 | (02) | WA |