SearchDistrict of Columbia374U00000X

Wanda Jackson

NPI 1538525175 · on the registry since 2016 · sole proprietor

Practice

Address
1709 L St Ne
Washington, DC 20002
Phone
(301) 613-5259

Registry record

Primary taxonomy
374U00000X
374U00000X
Licence states on file
DC
From the registry's licence fields, which are often incomplete.
Sex
Female
Record last updated
2016-01-12

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in District of Columbia