Individual
LAUREN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CCC-SLP
Contact information
Practice address
17912 NE 159TH ST, BRUSH PRAIRIE, WA 98606-9613
(360) 448-6400
Mailing address
4309 NE 105TH AVE, PORTLAND, OR 97220-3447
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL61341787
WA
Other
Enumeration date
11/07/2022
Last updated
11/07/2022
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