Individual
JACKIE MARIE JACQUES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA 16675171
Contact information
Practice address
29804 HIGHWAY 101, SUITE #5, QUILCENE, WA 98376
(360) 765-0888
Mailing address
PO BOX 578, SEQUIM, WA 98382-4309
(360) 649-5596
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
16675171
WA
Other
Enumeration date
02/22/2022
Last updated
02/22/2022
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