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Organization
MICHAEL R. JACKSON, M.D. P.S.
Active
Organization
MICHAEL R. JACKSON, M.D. P.S.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL R JACKSON M.D. (PRESIDENT)
(253) 472-4444
Entity
Organization
Contact information
Practice address
5350 ORCHARD ST W, SUITE 202, UNIVERSITY PLACE, WA 98467-4817
(253) 472-4444
Mailing address
5350 ORCHARD ST W, SUITE 202, UNIVERSITY PLACE, WA 98467-4817
(253) 472-4444
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0019523
WA
Other
Enumeration date
05/03/2012
Last updated
05/03/2012
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