Individual
MR. CLARK KENT JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSW
Contact information
Practice address
6 S 2ND ST, STE 918, YAKIMA, WA 98901-2632
(509) 961-8233
(509) 962-2286
Mailing address
2004 E 1ST AVE, ELLENSBURG, WA 98926-9021
(509) 933-4803
(509) 962-2286
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
LW6908
WA
Other
Enumeration date
09/15/2006
Last updated
07/08/2007
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