Individual
JAQUILINE MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MA
Contact information
Practice address
1617 CLEVELAND BLVD, CALDWELL, ID 83605-5029
(425) 582-2041
(425) 527-0468
Mailing address
5108 196TH ST SW C/O RXDX MEDICAL BILLING SVC LLC, STE, STE 310, LYNNWOOD, WA 98036-6152
(425) 256-7987
(888) 641-6642
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
COUI9732
ID
Other
Enumeration date
07/31/2024
Last updated
07/31/2024
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