Jaclyn Liese, RDH
NPI #1750041760 in Ferndale, Washington
Provider Information
- NPI Number
- 1750041760
- Entity Type
- Individual
- Name
- Jaclyn Liese, RDH
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Dental Hygienist
- Credential
- RDH
- Enumeration Date
- Dec 19, 2021
- Last Updated
- Jan 19, 2022
Practice Location
- Address
- 6060 PORTAL WAY
- City
- Ferndale
- State
- Washington
- ZIP Code
- 98248-7833
- Phone
- (360) 676-6177
Specialties & Taxonomy Codes
| Specialty |
|---|
| Dental Hygienist |
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