MEDICARE: MS. JESSICA WAI-YING TAM MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	MD60017883	WA
2	207R00000X	Internal Medicine Physician	6353479-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0237099	OTHER	WA	STATE L&I

General Provider Information

NPI Number	:	1013106582
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JESSICA WAI-YING TAM MD

Provider Business Mailing Address
First Line	:	1717 S J ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-4933
Country	:	US
Telephone Number	:	253-426-6341
Fax Number	:	253-426-6344

Provider Business Practice Location Address
First Line	:	1717 S J ST
Second Line	:
City	:	TACOMA
State	:	WA
Zip	:	98405-4933
Country	:	US
Telephone Number	:	253-426-6341
Fax Number	:	253-426-6344

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/19/2007
Last Update Date	:	03/03/2026

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