Provider Demographics
NPI:1093020315
Name:JAKISH, AHMAD (DVM, CCRP)
Entity Type:Individual
Prefix:DR
First Name:AHMAD
Middle Name:
Last Name:JAKISH
Suffix:
Gender:M
Credentials:DVM, CCRP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10131 WOOD LAKE RD
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:WA
Mailing Address - Zip Code:98272
Mailing Address - Country:US
Mailing Address - Phone:425-239-7452
Mailing Address - Fax:425-820-1717
Practice Address - Street 1:10131 WOODS LAKE RD
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:WA
Practice Address - Zip Code:98272-7815
Practice Address - Country:US
Practice Address - Phone:425-239-7452
Practice Address - Fax:425-820-1717
Is Sole Proprietor?:Yes
Enumeration Date:2010-08-11
Last Update Date:2010-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA8953174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian