MICHAEL BEN JACKSON

BREMERTON, WA
NPI1720199839
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363LP0808X Nurse Practitioner, Psych/Mental Health
(Licence: WA  ap30003880)
Enumeration Date2006-08-31
Last Update Date2007-07-08
Business Address
Mr. MICHAEL BEN JACKSON
925 ADELE AVE
BREMERTON, WA 98312-3521
Phone number: 360-782-0129
Mailing Address
Mr. MICHAEL BEN JACKSON
220 NE LARSON LAKE RD
BELFAIR, WA 98528-9404
Phone number: 360-782-0129
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