Marious Kim Jack MD

NPI 1407077019 - Optometrist - 152W00000X

NPI Details
NPI 1407077019
Gender Male
Enumeration Date 05/01/2007
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
1101-A BOYLSTON AVE
SEATTLE WA, 98101, US
Phone (206) 324-2006
Fax (206) 325-0209
Business Location
1101-A BOYLSTON AVE
SEATTLE WA, 98101, US
Phone (206) 324-2006
Fax (206) 325-0209
Toxanomy
Taxonomy Code 152W00000X
License State Washington
License Number MD5627
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According to our database, Dr. Marious Kim Jack MD NPI is 1407077019, taxonomy code is 152W00000X and license number is MD5627, license state is located at Washington. Marious Kim Jack MD physically located at 1101-a Boylston Ave, Seattle WA, 98101. NPI Number Marious Kim Jack MD has the Individual type.

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1407077019 NPI number is provided on an as is basis without warranty of any kind. 1407077019 is maintained by the National Plan & Provider Enumeration System. The contents of Marious Kim Jack MD are for informational purposes only.