Individual
SHELLY ARLENE JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN60434660
Contact information
Practice address
2901 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4614
(253) 534-7623
(253) 534-7610
Mailing address
2901 BRIDGEPORT WAY W, UNIVERSITY PLACE, WA 98466-4614
(253) 534-7623
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
RN60434660
WA
Other
Enumeration date
11/24/2023
Last updated
11/24/2023
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