Individual
JACKIE ST MARIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
1014 BURRELL AVE, LEWISTON, ID 83501-5472
(208) 743-4558
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(971) 364-0611
(971) 364-0610
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
—
—
Other
Enumeration date
12/16/2021
Last updated
12/16/2021
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