Pete A. Jacques, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA10001731 Issued in WA

Practice address

2202 S Cedar St
Ste. #310
Tacoma, WA 98405-2318

Phone

(253) 272-5127

Fax

(253) 404-0506

NPI assigned

Feb 13, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Western Washington Endoscopy Centers, LLC

  • Ambulatory Surgical Clinic/Center
  • Tacoma, WA
  • NPI 1295700086
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1139788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1245024000000",
    "number": "1104890656",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1241",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984011241",
            "telephone_number": "253-272-5127",
            "fax_number": "253-404-0506"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2202 S CEDAR ST",
            "address_2": "STE. #310",
            "city": "TACOMA",
            "state": "WA",
            "postal_code": "984052318",
            "telephone_number": "253-272-5127",
            "fax_number": "253-404-0506"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACQUES",
        "first_name": "PETE",
        "middle_name": "A.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-13",
        "last_updated": "2009-06-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA10001731",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WA LICENSE",
            "identifier": "PA10001731",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Seth Joseph Jacobson, RN
• Matthew Paul Jacobsson, DO
• Carolyn M Jacoby, LCSW
• Miguel Jacome Jr., EFDA ASSISTANT
• Nicolae Ion Jacot, AA
• Dorothy M Jaeger
• Zubeir Noordin Jaffer, MD
• Afzaal Iman Jafri
• Miloni Jagad
• Amy Jagger, DVM

• Medical Physician Assistant in Tacoma, WA
• Providers in Tacoma, WA by specialty
• Medical Physician Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 15, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.