Individual
EDWARD I JACKSON SR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2133 3RD AVE, SEATTLE, WA 98121-2385
(213) 339-8121
Mailing address
952 SW CAMPUS DR APT 47A1, FEDERAL WAY, WA 98023-5041
(253) 951-8799
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
03/20/2023
Last updated
03/20/2023
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