SAMUEL JACKSON

SEATTLE, WA
NPI1255794160
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2084P0800X Psychiatry & Neurology, Psychiatry
(Licence: WA  MD61035793)
Enumeration Date2016-03-30
Last Update Date2022-08-25
Business Address
SAMUEL JACKSON
825 EASTLAKE AVE E
SEATTLE, WA 98109-4405
Phone number: 206-520-5000
Mailing Address
SAMUEL JACKSON
PO BOX 50095
SEATTLE, WA 98145-5095
Phone number:
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