Individual
JACKIE M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6512 20TH STREET CT W STE B2, FIRCREST, WA 98466-6212
(253) 468-7899
Mailing address
1942 CRYSTAL SPRINGS RD W, TACOMA, WA 98466-2910
(920) 471-3419
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
RC00055212
WA
1041C0700X
Clinical Social Worker
Primary
60336105
WA
Other
Enumeration date
12/19/2007
Last updated
07/21/2022
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