Mr. JACKSON GREY LIKENS PA-C
Individual Provider (NPI-1)
Active
Physician Assistant
Provider Information
- NPI Number
1851075477- Provider Type
- Individual Provider (NPI-1)
- Credentials
- PA-C
- Status
- Active
Contact & Location
- Address
- 3651 ASHWORTH AVE N UNIT B, SEATTLE, WA, 981038116
- Phone
- (407) 927-1656
Specialties & Taxonomies
Physician Assistant
License: FL #9116959
Physician Assistant
Primary License: WA #PA61450103