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Individual

TANYA NAN YOUNG JACKINS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
370 S MARKET BLVD, CHEHALIS, WA 98532-3042
(360) 748-6693
(360) 748-3619
Mailing address
415 CRAFTSMAN DR NW, OLYMPIA, WA 98502-2639
(360) 669-9479

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP61620108
WA

Other

Enumeration date
10/23/2024
Last updated
10/23/2024
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