Individual
CANDY L JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.
Contact information
Practice address
1803 W MAXWELL AVE, SPOKANE, WA 99201-2831
(509) 325-5502
(509) 325-9839
Mailing address
505 E NORTH FOOTHILLS DR, SPOKANE, WA 99207-2101
(509) 483-7535
(509) 483-9460
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
DI00001765
WA
Other
Enumeration date
10/19/2005
Last updated
08/10/2009
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