Provider Demographics
NPI:1669799755
Name:YOUNG, JESSIE LYN (DC)
Entity type:Individual
Prefix:DR
First Name:JESSIE
Middle Name:LYN
Last Name:YOUNG
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
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Mailing Address - Street 1:422 W RIVERSIDE AVE STE 1100
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99201-0302
Mailing Address - Country:US
Mailing Address - Phone:360-819-9700
Mailing Address - Fax:360-570-0332
Practice Address - Street 1:1910 BLACK LAKE BLVD SW # 103
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98512-5651
Practice Address - Country:US
Practice Address - Phone:360-352-8112
Practice Address - Fax:360-570-0332
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-28
Last Update Date:2021-02-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WACH60908669111NP0017X, 111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
No111NP0017XChiropractic ProvidersChiropractorPediatric Chiropractor