LACEY JACKSON, LMP

Specialist

Active Individual
NPI: 1417096082

Practice Address

712 TROSPER RD SW
Tumwater, WA 98512

Phone: (360) 570-2273

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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