LACEY JACKSON, LMP
Specialist
Active
Individual
NPI: 1417096082
Specialties
| Specialty | Code | Primary | License |
|---|---|---|---|
| Specialist | 174400000X | Yes | MA00013081 (WA) |
Frequently Asked Questions
NPI 1417096082 is the National Provider Identifier for LACEY JACKSON, LMP, a Specialist provider located in Tumwater, WA. This NPI was enumerated on February 6, 2007.
LACEY JACKSON, LMP practices at 712 TROSPER RD SW, Tumwater, WA 98512.
Quick Facts
- NPI
- 1417096082
- Type
- Individual
- Enumerated
- Feb 6, 2007
- Last Updated
- Jul 8, 2007
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