Individual
SEAN JACQUAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
714 W PINE ST, NEWPORT, WA 99156-9046
(509) 447-9308
Mailing address
412 N SPOKANE AVE, NEWPORT, WA 99156-9012
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
60704704
WA
Other
Enumeration date
11/14/2016
Last updated
11/14/2016
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