Individual
JESIQUA RENEE MATYAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
902 PINE ST, EVERETT, WA 98201-1403
(425) 610-2075
Mailing address
7440 W MARGINAL WAY S, SEATTLE, WA 98108-4141
(425) 610-2075
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
09/21/2023
Last updated
09/21/2023
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