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1770211047
JACOB PHILLIPS
RIDGEFIELD, WA
NPI
1770211047
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
175T00000X Peer Specialist
(Licence: WA CG61240416)
Enumeration Date
2022-08-12
Last Update Date
2022-08-12
Business Address
JACOB PHILLIPS CPC
21810 NE 37TH AVE
RIDGEFIELD, WA 98642-7747
Phone number: 360-241-5695
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Mailing Address
JACOB PHILLIPS CPC
PO BOX 1299
BATTLE GROUND, WA 98604-1299
Phone number: 360-241-5695
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