Individual
JENELLE DIANE ERICKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3220 113TH AVE NE, LAKE STEVENS, WA 98258-9573
(425) 335-1585
Mailing address
11802 1ST PL SE, LAKE STEVENS, WA 98258-7736
(425) 280-8844
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL61093228
WA
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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