Individual
JACLYN J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
6005 TYEE DR SW, TUMWATER, WA 98512-7356
(360) 464-6867
Mailing address
1013 COMMERCIAL ST, RAYMOND, WA 98577
(503) 791-0096
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CO61227019
WA
Other
Enumeration date
10/25/2021
Last updated
10/25/2021
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