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General NPI Number Information
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NPI Number | 1982059572
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Entity Type | Individual
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Provider Name | JESSCA MCCORD L.AC.
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Gender | Female
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Dates
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Enumeration Date | 05/02/2016
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Last Update Date | 09/30/2016
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Provider Practice Location Address
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Address Line | 221 2ND ST STE 7A
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City | LANGLEY
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State | WA
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Zip | 98260-8664
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Country | US
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Telephone | 360-320-0788
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Fax |
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Provider Business Mailing Address
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Address Line | 2135 GOSS LAKE RD
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City | FREELAND
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State | WA
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Zip | 98249-9511
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Country | US
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Telephone | 360-320-0788
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | AC60635818
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License Number State | WA
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