ADAM JACKSON

KINGSTON, WA
NPI1942734884
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WA  CO60375850)
Enumeration Date2017-04-18
Last Update Date2017-04-18
Business Address
Mr. ADAM JACKSON CDPT
31912 LITTLE BOSTON RD NE
KINGSTON, WA 98346-9700
Phone number: 360-297-6329
Mailing Address
Mr. ADAM JACKSON CDPT
21324 SISTER SKY LN NE
INDIANOLA, WA 98342-9706
Phone number: 360-535-4535
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