Individual
MS. JACQUELINE MICHELLE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTA/L
Contact information
Practice address
2005 N 33RD PL, MOUNT VERNON, WA 98273-9102
(206) 854-8449
Mailing address
2005 N 33RD PL, MOUNT VERNON, WA 98273-9102
(206) 854-8449
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
00000784
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00000784
WASHINGTON STATE LICENSE NUMBER FOR OCCUPATION THERAPY ASSISTANT
WA
Enumeration date
04/10/2013
Last updated
11/20/2023
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