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1912996257
CANDY L JACKSON
SPOKANE, WA
NPI
1912996257
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
133V00000X Dietitian, Registered
(Licence: WA DI00001765)
Enumeration Date
2005-10-19
Last Update Date
2009-08-10
Business Address
-- CANDY L JACKSON R.D.
1803 W MAXWELL AVE
SPOKANE, WA 99201-2831
Phone number: 509-325-5502
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Mailing Address
-- CANDY L JACKSON R.D.
505 E NORTH FOOTHILLS DR
SPOKANE, WA 99207-2101
Phone number: 509-483-7535
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