Individual
DEBORAH OLIVIA JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
601 S 8TH ST, TACOMA, WA 98405-4614
(253) 571-1000
Mailing address
2529 S HOSMER ST, TACOMA, WA 98405-3151
(253) 222-6971
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OC00000143
WA
Other
Enumeration date
12/05/2012
Last updated
12/05/2012
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