Individual
MICHAEL THOMAS JACEZKO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1660 S COLUMBIAN WAY, SEATTLE, WA 98108-1532
(206) 762-1010
Mailing address
430 12TH AVE E APT 207, SEATTLE, WA 98102-5149
(314) 707-6778
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
70012996
WA
Other
Enumeration date
08/21/2025
Last updated
08/21/2025
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