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P.C. JAIL CLINIC

Custodial Care Facility

Tacoma, Washington

Provider NPI: 1699828103

Organization Information:
Organization Name:  P.C. JAIL CLINIC


Practice Location:
910 TACOMA AVE S  TACOMA, WA 98402 US
Tel: 253-798-4033  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y311Z00000XNursing & Custodial Care Facilities
Custodial Care Facility

Other Provider Identifiers:

IssuerNumberStateType
MEDICAL LICENSEMD00034248WA01
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




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