Individual
SHARON JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
2308 W 3RD AVE, SPOKANE, WA 99201-5810
(509) 624-1244
Mailing address
PO BOX 4627, SPOKANE, WA 99220-0627
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP60956363
WA
Other
Enumeration date
06/14/2018
Last updated
01/27/2020
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