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1861998155
GINA MARIE JACKSON
LAKEWOOD, WA
NPI
1861998155
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Former Name
GINA MARIE TELLEF
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2018-04-04
Last Update Date
2018-04-04
Business Address
GINA MARIE JACKSON CMA
9330 59TH AVE SW
LAKEWOOD, WA 98499-2858
Phone number: 253-620-5015
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Mailing Address
GINA MARIE JACKSON CMA
9330 59TH AVE SW
LAKEWOOD, WA 98499-2858
Phone number: 253-620-5015
Copy
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