Individual
JACOB ANDERSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1905 DANIELS ST APT 10, VANCOUVER, WA 98660-2500
(231) 620-7445
Mailing address
1905 DANIELS ST APT 10, VANCOUVER, WA 98660-2500
(231) 620-7445
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
—
Other
Enumeration date
07/01/2019
Last updated
07/01/2019
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