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Individual

MS. JACKIE HYMAN BLAIR

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MED.,CDP

Contact information

Practice address
1601 E FOURTH PLAIN BLVD, VANCOUVER, WA 98661-3753
(360) 397-8246
(360) 397-8450
Mailing address
PO BOX 871206, VANCOUVER, WA 98687-1206
(360) 606-1672
(360) 397-8450

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary

Other

Enumeration date
06/15/2009
Last updated
06/15/2009
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