Individual
CARRIE ANNE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
25615 104TH AVE SE, KENT, WA 98030-7609
(253) 872-2030
Mailing address
6050 TACOMA MALL BLVD STE 300, TACOMA, WA 98409-6828
(253) 581-5200
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT61350437
WA
Other
Enumeration date
09/21/2022
Last updated
09/21/2022
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