Individual
JESSICA STARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PSYD
Contact information
Practice address
450 NW GILMAN BLVD STE 201, ISSAQUAH, WA 98027-2722
(425) 835-2503
Mailing address
450 NW GILMAN BLVD STE 201, ISSAQUAH, WA 98027-2722
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
PY60876949
WA
Other
Enumeration date
12/06/2018
Last updated
12/06/2018
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