Individual
MS. EHREN JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
25 95TH DR NE STE 105, LAKE STEVENS, WA 98258-7976
(425) 334-9137
Mailing address
4214 84TH ST NE APT 5, MARYSVILLE, WA 98270-3457
(206) 880-3177
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA60371251
WA
Other
Enumeration date
06/24/2016
Last updated
12/22/2019
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