Individual
KIMMISHA JACKSON ROYAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9600 VETERANS DR SW, TACOMA, WA 98493-6638
(253) 582-8440
(253) 589-4143
Mailing address
9712 18TH AVENUE CT S APT R14, TACOMA, WA 98444-6638
(253) 355-7097
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
61492022
WA
Other
Enumeration date
12/18/2023
Last updated
12/18/2023
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