Individual provider · Type 1 NPI

Kelly Colleen Jackson, CDPT

Addiction (Substance Use Disorder) Counselor · Everett, WA

NPI number 1629544655 Active

Practice location

811 Madison St
Everett, WA 98203-4543

Call (425) 212-4200 Map

Fax (425) 212-4201

Mailing address

PO Box 2569
Everett, WA 98213-0569

Specialties and licenses

TaxonomyCodeLicense
Addiction (Substance Use Disorder) Counselor Primary 101YA0400XCO60869651 (WA)

Addiction (Substance Use Disorder) Counselor: Definition to come...

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About NPI 1629544655

Kelly Colleen Jackson, CDPT's National Provider Identifier is 1629544655, issued on Oct 17, 2018. The primary taxonomy on file is Addiction (Substance Use Disorder) Counselor (101YA0400X), and the practice location is in Everett, WA. The record was last updated on May 13, 2019.