Individual
LISA MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
33455 6TH AVE S # 2C, FEDERAL WAY, WA 98003-6074
(253) 210-4230
Mailing address
11723 SE 157TH ST, RENTON, WA 98058-4636
(253) 229-0660
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
MHCA.MC.61464859
WA
101YP2500X
Professional Counselor
Primary
—
—
Other
Enumeration date
07/25/2023
Last updated
03/21/2025
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