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Individual

MR. JAMES ALLEN JACKSON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.S.W.

Contact information

Practice address
5209 POINT FOSDICK DR NW STE 205, GIG HARBOR, WA 98335
(253) 495-9311
Mailing address
5209 POINT FOSDICK DR NW STE 205, GIG HARBOR, WA 98335-1728
(253) 495-9311
(253) 697-3730

Taxonomy

Speciality
Code
Description
License number
State
104100000X
Social Worker
1041C0700X
Clinical Social Worker
Primary
LW00004709
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
LW00004709
WA STATE DEPARTMENT OF HEALTH
WA
Enumeration date
06/14/2011
Last updated
05/18/2019
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