Individual
JEANA JACOBSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1570 WILMINGTON DR STE 220, DUPONT, WA 98327-8773
(206) 453-4882
Mailing address
3335 MARTIN WAY E APT 305, OLYMPIA, WA 98506-4947
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
06/02/2020
Last updated
06/02/2020
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