Healthcare Provider Details

I. General information

NPI: 1265345854
Provider Name (Legal Business Name): JAK & COMPANY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/24/2026
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3923 8TH ST NW
WASHINGTON DC
20011-7905
US

IV. Provider business mailing address

3923 8TH ST NW
WASHINGTON DC
20011-7905
US

V. Phone/Fax

Practice location:
  • Phone: 202-938-8705
  • Fax:
Mailing address:
  • Phone: 202-938-8705
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code372500000X
TaxonomyChore Provider
License Number
License Number State

VIII. Authorized Official

Name: TYAISHIA JACKSON
Title or Position: COORDINATOR
Credential:
Phone: 202-938-8705