Individual
JACLYN POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS RD
Contact information
Practice address
2020 E 29TH AVE, SUITE 200, SPOKANE, WA 99203-3917
(509) 252-1366
Mailing address
1305 S MADISON ST, SPOKANE, WA 99204-3968
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1095105
AND
—
Enumeration date
09/15/2016
Last updated
09/15/2016
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