Provider Demographics
NPI:1497022123
Name:JAGGER, AMY (DVM)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:
Last Name:JAGGER
Suffix:
Gender:F
Credentials:DVM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14107 PACIFIC AVE S
Mailing Address - Street 2:SUITE A
Mailing Address - City:TACOMA
Mailing Address - State:WA
Mailing Address - Zip Code:98444-4622
Mailing Address - Country:US
Mailing Address - Phone:253-531-0454
Mailing Address - Fax:253-537-5368
Practice Address - Street 1:14107 PACIFIC AVE S
Practice Address - Street 2:SUITE A
Practice Address - City:TACOMA
Practice Address - State:WA
Practice Address - Zip Code:98444-4622
Practice Address - Country:US
Practice Address - Phone:253-531-0454
Practice Address - Fax:253-537-5368
Is Sole Proprietor?:No
Enumeration Date:2011-11-23
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAVT 60211131174M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174M00000XOther Service ProvidersVeterinarian