DR. JACK RONALD TACKER (M.D.) – General Practice Physician, NPI 1336379403

DR. JACK RONALD TACKER (M.D.) is a healthcare provider. based in Poulsbo, Washington. specializing in General Practice Physician. They hold the professional credentials M.D.. They hold a License No. MD00028053 (WA). The NPI Number for DR. JACK RONALD TACKER (M.D.) is 1336379403

Main info

Male
Sole Proprietor
64 Years Of Experience
Accepts Medicare Assignment
Name
DR. JACK RONALD TACKER (M.D.)
NPI
1336379403
Phone
(360) 779-7500
Address
PO BOX 127
Enumeration Date
22 July 2009
Last Update Date
5 June 2013

Doctor Profile

Medical School Name
UNIVERSITY OF OKLAHOMA COLLEGE OF MEDICINE
Secondary Phone
3604796041
Graduation Year
1962 (64 years ago)
PAC ID
5799966263
Group Practice PAC ID
7618969643
Professional Enrollment ID
I20110217000172
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience46
Completeness75
Years active:16State licenses:1Digital endpointsOther names

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Provider Addresses for DR. JACK RONALD TACKER (M.D.)

  • PO BOX 127

    POULSBO, WA 983700127

    Phone: (360) 779-7500

    Fax: (253) 288-2203

    Type: Mailing

  • Marth & Mary, 19160, Front Street Northeast, Poulsbo, Kitsap County, Washington, 98370, United States

    POULSBO, WA 98370

    Phone: (360) 779-7500

    Fax: (360) 626-0600

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 98370)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7618969643View full group profile
NameSpecialtyState
SANDRA M CLAUSON (ARNP)
Nurse PractitionerWA
HEATHER LYNN SMITH-MERRITHEW
Nurse PractitionerTX
MERIDITH MARGARET HALLOWELL (ARNP)
Nurse PractitionerWA
DR. DONALD L SHARMAN (MD)
Internal MedicineWA
DR. WILLIAM M. BAUER (MD)
Internal MedicineWA

Reviews

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Frequently asked questions

What is the 10-digit NPI for DR. JACK RONALD TACKER (M.D.)?
DR. JACK RONALD TACKER (M.D.) — NPI 1336379403 — is the standard way to identify this listing.
Does the file indicate DR. JACK RONALD TACKER (M.D.) is practicing under active NPI?
Directory data currently reports DR. JACK RONALD TACKER (M.D.) as active.
What is DR. JACK RONALD TACKER (M.D.) best known for clinically?
Directory data describes DR. JACK RONALD TACKER (M.D.) with General Practice Physician. Clinical services aligned with this taxonomy classification.
Where should I expect DR. JACK RONALD TACKER (M.D.) on a map?
Expect Poulsbo, Washington as a primary anchor for DR. JACK RONALD TACKER (M.D.) unless the record lists multiple sites.
What does 'Individual Provider' mean on this profile?
Entity type tells you whether the number belongs to a person or an organization.

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