Search › Washington › 152W00000X
Jeffrey Tack, OD
NPI 1710046610 · on the registry since 2006
Practice
- Address
- 820 Ocean Beach Hwy
Suite 100
Longview, WA 98632 - Phone
- (360) 636-2020
- Organisation at this address
- Mountain Smiles, Pllc
Longview Eye & Vision
Smiles Dental Group, Pc
Jeromy R. Dixson, D.M.D., P.S.
Johnson, Dixson & Pond DentistryInferred from a shared address, not stated in the registry. - Clinicians at this address
- 18
Registry record
- Primary taxonomy
- 152W00000X
152W00000X
- Also registered as
- 152WC0802X
152WL0500X
152WP0200X
152WS0006X
152WV0400X
152WX0102X - Licence states on file
- WA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-05-02
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Washington