Individual
KATHRYN JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
18422 103RD AVE NE, BOTHELL, WA 98011-3410
(425) 949-0801
Mailing address
22327 MERIDIAN AVE S, BOTHELL, WA 98021-8311
(425) 236-3569
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
BAC804127
WA
Other
Enumeration date
06/20/2022
Last updated
06/20/2022
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