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DR. JACK RONALD TACKER M.D.
NPI 1336379403
General Practice in Poulsbo, WA

Active since July 22, 2009
19160 FRONT ST NE, POULSBO, WA 98370(360) 779-7500(360) 626-0600 Get Directions Write a Review

NPPES record last updated: June 5, 2013. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Dr. Jack Ronald Tacker M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. JACK RONALD TACKER M.D. (NPI 1336379403) is an individual general practice provider in Poulsbo, Washington, licensed in Washington (MD00028053) and active in the NPI registry since July 2009.

NPPES Registry Identity

NPI1336379403
Entity TypeIndividualMale
Primary Taxonomy208D00000X
Provider Legal NameDR. JACK RONALD TACKERCredential: M.D.
Location Address19160 FRONT ST NEPoulsbo, WA 98370
Mailing AddressPo Box 127Poulsbo, WA 98370-0127 · (360) 779-7500 · Fax (253) 288-2203
Phone(360) 779-7500
Fax(360) 626-0600
Sole ProprietorYes
Enumeration DateJuly 22, 2009
Last NPPES UpdateJune 5, 2013
✔ NPI 1336379403 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyGeneral PracticeAllopathic & Osteopathic Physicians
Taxonomy Code208D00000X
License✔ Licensed in WA · MD00028053
Definition
A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions. Source: National Uniform Claim Committee
19160 FRONT ST NE, Poulsbo, WA 98370
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Other Identifiers 1

Medicare UPINA 47684CA

Other Providers at the Same Location NPPES 7

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

HANNA HOSKINS
Physical Therapy Assistant
19160 FRONT ST NE
POULSBO, WA 98370
Kitsap County (360) 779-7500
LISA PATUREAU
Occupational Therapy Assistant
19160 FRONT ST NE
POULSBO, WA 98370
Kitsap County (360) 779-7500
BRITTANY LEEANN HEDIN COTA
Occupational Therapy Assistant
19160 FRONT ST NE
POULSBO, WA 98370
Kitsap County (360) 779-7500
SARAH MARIAH WEIS
Physical Therapy Assistant
19160 FRONT ST NE
POULSBO, WA 98370
Kitsap County (360) 779-7500
ALICIA AMY WILLIAMS PTA
Physical Therapy Assistant
19160 FRONT ST NE
POULSBO, WA 98370
Kitsap County (360) 779-7500
MARTHA AND MARY HEALTH SERVICES
Skilled Nursing Facility
19160 FRONT ST NE
POULSBO, WA 98370
Kitsap County (360) 779-7500
MRS. ALAIRE CALL LOWE MA, CCC-SLP
Speech-Language Pathologist
19160 FRONT ST NE
POULSBO, WA 98370
Kitsap County (360) 779-7500

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jack Tacker's NPI number?

The NPI number for Jack Tacker is 1336379403. It was assigned to this individual provider in the NPPES registry on July 22, 2009.

Where is Jack Tacker located?

Jack Tacker practices at 19160 Front St NE, Poulsbo, WA 98370. The listed phone number is (360) 779-7500.

What is Jack Tacker's specialty?

The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.

When was this NPI record last updated?

The NPPES record for Jack Tacker was last updated on June 5, 2013. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 13 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.