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Individual

MRS. JACKIE MICHELLE FOURNIER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSW, LICSW

Contact information

Practice address
9600 VETERANS DR SW, TACOMA, WA 98493-0003
(253) 582-8440
Mailing address
10414 178TH AVE E, BONNEY LAKE, WA 98391-5143
(253) 447-4268

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
1041C0700X
Clinical Social Worker
LW00009459
WA

Other

Enumeration date
08/30/2006
Last updated
08/28/2007
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