Individual
MICHELLE N JAQUISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LICSW
Contact information
Practice address
6314 19TH ST W STE 7, FIRCREST, WA 98466-6223
(601) 206-8735
Mailing address
6314 19TH ST W STE 7, FIRCREST, WA 98466-6223
(601) 206-8735
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW61115906
WA
Other
Enumeration date
11/07/2018
Last updated
01/13/2025
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