Individual
JESSICA MT DUBOSE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW, LICSW
Contact information
Practice address
1200 SW 27TH ST, RENTON, WA 98057-2603
(206) 630-1680
Mailing address
1200 SW 27TH ST, RENTON, WA 98057-2603
(206) 630-1680
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW60205596
WA
Other
Enumeration date
10/06/2015
Last updated
11/14/2022
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