Individual
JACOB WASH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1570 WILMINGTON DR STE 220, DUPONT, WA 98327-8773
(206) 453-4882
Mailing address
7215 N FOTHERINGHAM ST, SPOKANE, WA 99208-4878
(509) 828-7057
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WA
Other
Enumeration date
12/09/2021
Last updated
12/09/2021
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