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Individual

ISATOU JAMMEH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
805 112TH ST SE APT C302, EVERETT, WA 98208-8021
(425) 829-0124
Mailing address
PO BOX 4311, EVERETT, WA 98204-0032

Taxonomy

Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
CB61000541
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
604711608-001-0001
LICENSE
WA
Enumeration date
02/12/2021
Last updated
02/12/2021
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