Provider Demographics
NPI:1437311925
Name:SIZER, JACQUELINE A (LMP)
Entity Type:Individual
Prefix:MISS
First Name:JACQUELINE
Middle Name:A
Last Name:SIZER
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:MRS
Other - First Name:JACQUELINE
Other - Middle Name:A
Other - Last Name:WHEATLEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2722 LOCUST AVE W
Mailing Address - Street 2:
Mailing Address - City:UNIVERSITY PLACE
Mailing Address - State:WA
Mailing Address - Zip Code:98466-3409
Mailing Address - Country:US
Mailing Address - Phone:253-278-2224
Mailing Address - Fax:253-565-1261
Practice Address - Street 1:2722 LOCUST AVE W
Practice Address - Street 2:
Practice Address - City:UNIVERSITY PLACE
Practice Address - State:WA
Practice Address - Zip Code:98466-3409
Practice Address - Country:US
Practice Address - Phone:253-278-2224
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-26
Last Update Date:2021-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00022067172V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker