Individual
JACLENE MARIE ROSALES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
8414 JOHN DOWER RD SW UNIT 12, LAKEWOOD, WA 98499-2574
(419) 701-9284
Mailing address
20034 OTOOLE RD SE, YELM, WA 98597-9046
(360) 894-1493
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
212292901
DSHS (DEPARTMENT OF SOCIAL & HEALTH SERVICES)
WA
Enumeration date
07/24/2019
Last updated
07/24/2019
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