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1013493477
KIMIKO RENA JACKSON
TACOMA, WA
NPI
1013493477
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: WA LP60276858)
Enumeration Date
2018-07-18
Last Update Date
2018-07-18
Business Address
Mrs. KIMIKO RENA JACKSON LPN
3629 S D ST
TACOMA, WA 98418-6813
Phone number: 253-798-4612
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Mailing Address
Mrs. KIMIKO RENA JACKSON LPN
3629 S D ST
TACOMA, WA 98418-6813
Phone number: 253-798-4612
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