Individual
JACQUELINE MANNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NONE
Contact information
Practice address
6400 SOUTHCENTER BLVD, TUKWILA, WA 98188-2547
(206) 901-2000
Mailing address
6400 SOUTHCENTER BLVD., TUKWILA, WA 98188
(206) 901-2000
(206) 901-2010
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
106S00000X
Behavior Technician
BACB655567
WA
106S00000X
Behavior Technician
—
WA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
11/12/2021
Last updated
09/23/2024
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