Individual
AMY JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
13010 NE 20TH ST, SUITE 300, BELLEVUE, WA 98005-2034
(425) 644-6328
Mailing address
1410 1ST ST, PRINCETON, MN 55371-1410
(612) 390-5415
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT60316091
WA
Other
Enumeration date
07/22/2013
Last updated
07/22/2013
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