Jackson, Jerrold

Jackson, Jerrold is an individual health care provider with primary practice located at 10216 Beacon Ave S , Tukwila WA 98178-2039. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Counselor, Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is his primary health care specialty. Jackson, Jerrold can be contacted via phone (425) 761-9469.

Contact Information

Primary practice address
10216 Beacon Ave S Tukwila WA 98178-2039
Phone: (425) 761-9469
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Counselor 101Y00000X
Behavioral Health & Social Service Providers / Mental Health 101YM0800X LH61262872 Washington

Profile Details

NPI number 1598021081
LBN Legal business name Jackson, Jerrold
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 9th, 2012
Last updated Sep 30th, 2024 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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