Individual
JESSICA DICKERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
9040 JACKSON AVE, TACOMA, WA 98431-1100
(253) 968-3105
Mailing address
11318 185TH ST E, PUYALLUP, WA 98374-8878
(253) 355-1879
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
OP60700638
WA
Other
Enumeration date
10/03/2016
Last updated
10/03/2016
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