Liese, Jaclyn

Liese, Jaclyn is an sole proprietor health care provider with primary practice located at 6060 Portal Way , Ferndale WA 98248-7833. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Liese, Jaclyn can be contacted via phone (360) 676-6177.

Contact Information

Primary practice address
6060 Portal Way Ferndale WA 98248-7833
Phone: (360) 676-6177
Fax: (360) 671-3574
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X DEHY.DH.61078723 Washington

Profile Details

NPI number 1750041760
LBN Legal business name Liese, Jaclyn
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Dec 19th, 2021
Last updated Jan 19th, 2022 - about 3 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.

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