Lacey Jackson, LMP
NPI #1417096082 in Tumwater, Washington
Provider Information
- NPI Number
- 1417096082
- Entity Type
- Individual
- Name
- Lacey Jackson, LMP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Specialist
- Credential
- LMP
- Enumeration Date
- Feb 6, 2007
- Last Updated
- Jul 8, 2007
Practice Location
- Address
- 712 TROSPER RD SW
- City
- Tumwater
- State
- Washington
- ZIP Code
- 98512-6934
- Phone
- (360) 570-2273
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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