Individual
JENNIFER JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AAC
Contact information
Practice address
1616 S GOLD ST STE 4, CENTRALIA, WA 98531-8930
(360) 807-4929
(360) 807-4160
Mailing address
PO BOX 2394, LONGVIEW, WA 98632-8455
(360) 200-5419
(360) 200-6736
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
WA
Other
Enumeration date
01/12/2021
Last updated
01/12/2021
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