KELLY COLLEEN JACKSON

EVERETT, WA
NPI1629544655
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO60869651)
Enumeration Date2018-10-17
Last Update Date2019-05-13
Business Address
KELLY COLLEEN JACKSON CDPT
811 MADISON ST
EVERETT, WA 98203-4543
Phone number: 425-212-4200
Mailing Address
KELLY COLLEEN JACKSON CDPT
PO BOX 2569
EVERETT, WA 98213-0569
Phone number: 425-212-4200