Individual
JACQUELINE WAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-3208
Mailing address
9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-3208
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP00052959
WA
Other
Enumeration date
06/06/2016
Last updated
06/06/2016
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