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1902047954
SUSAN R. RENEE JACKSON
TUMWATER, WA
NPI
1902047954
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
225700000X Massage Therapist
(Licence: WA MA60073078)
Enumeration Date
2009-03-19
Last Update Date
2009-03-19
Business Address
MS. SUSAN R. RENEE JACKSON LMP
511 N 7TH AVE SW
TUMWATER, WA 98512-6305
Phone number: 360-790-9195
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Mailing Address
MS. SUSAN R. RENEE JACKSON LMP
511 N 7TH AVE SW
TUMWATER, WA 98512-6305
Phone number: 360-790-9195
Copy
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