Individual
PEGGY ANN JACKSON-OMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14692 179TH AVE SE, MONROE, WA 98272-1198
(360) 804-2500
Mailing address
7311 59TH ST NE, MARYSVILLE, WA 98270-8883
(360) 658-5315
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
LL60680388
WA
Other
Enumeration date
10/19/2021
Last updated
10/19/2021
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