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1629544655
KELLY COLLEEN JACKSON
EVERETT, WA
NPI
1629544655
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA CO60869651)
Enumeration Date
2018-10-17
Last Update Date
2019-05-13
Business Address
KELLY COLLEEN JACKSON CDPT
811 MADISON ST
EVERETT, WA 98203-4543
Phone number: 425-212-4200
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Mailing Address
KELLY COLLEEN JACKSON CDPT
PO BOX 2569
EVERETT, WA 98213-0569
Phone number: 425-212-4200
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