Individual
JAQUELINE CARRASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA-C
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
CM60504139
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CM60504139
MA LICENSE
WA
Enumeration date
11/15/2019
Last updated
11/15/2019
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