Jack F Lake, PA-C
NPI #1427069889 in Milton, Washington
Provider Information
- NPI Number
- 1427069889
- Entity Type
- Individual
- Name
- Jack F Lake, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Aug 11, 2006
- Last Updated
- Nov 16, 2010
Practice Location
- Address
- 2748 MILTON WAY
- Address 2
- STE 101
- City
- Milton
- State
- Washington
- ZIP Code
- 98354-9382
- Phone
- (253) 922-5262
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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