Individual
JACQUELINE PARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5617 N GROVE DR, MUKILTEO, WA 98275-4868
(425) 463-7992
Mailing address
5617 N GROVE DR, MUKILTEO, WA 98275-4868
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
08/09/2023
Last updated
11/09/2023
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