Individual
DR. TERISA MARIE JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
N.D.
Contact information
Practice address
711 KUPULAU DR, KIHEI, HI 96753-9349
(206) 393-2566
(206) 319-4603
Mailing address
711 KUPULAU DR, KIHEI, HI 96753-9349
(206) 393-2566
(206) 319-4603
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
ND-249
HI
Other
Enumeration date
05/07/2012
Last updated
03/26/2014
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