Individual
GENELLE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1227 2ND ST, MARYSVILLE, WA 98270-4906
(360) 651-2366
Mailing address
23121 40TH DR NE, ARLINGTON, WA 98223-7677
(425) 231-0709
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
WA
Other
Enumeration date
08/20/2025
Last updated
08/20/2025
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