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1467823104
MICHAEL JACKSON
TACOMA, WA
NPI
1467823104
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: WA OC 60534324)
Enumeration Date
2015-10-07
Last Update Date
2015-10-07
Business Address
Mr. MICHAEL JACKSON COTA
1913 N OAKES ST APT D
TACOMA, WA 98406-7527
Phone number: 253-223-3590
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Mailing Address
Mr. MICHAEL JACKSON COTA
1913 N OAKES ST APT D
TACOMA, WA 98406-7527
Phone number: 253-223-3590
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