Jackson, Stacey Marie

Jackson, Stacey Marie is an individual health care provider with primary practice located at 701 Hospital Loop , Fairchild Afb WA 99011-8704. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Clinical, Student, Health Care / Student in an Organized Health Care Education/Training Program. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Jackson, Stacey Marie can be contacted via phone (509) 247-3852.

Contact Information

Primary practice address
701 Hospital Loop Fairchild Afb WA 99011-8704
Phone: (509) 247-3852
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 103TC0700X 08100006337 Virginia
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X

Profile Details

NPI number 1588189310
LBN Legal business name Jackson, Stacey Marie
Credentials PSYD
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 14th, 2017
Last updated Aug 15th, 2023 - 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.

Request for update

Popular Providers